Insights from BeOne Medicines Presentations at ASH 2025: Defining Durability with Long-Term Efficacy and Safety Data of Zanubrutinib in TN CLL/SLL
Heather Arranie 
The American Society of Hematology (ASH) 2025 Annual Meeting is once again at the forefront of clinical and scientific innovation, hosting the release of critical data that will influence the future management of blood cancers. A major area of focus this year involves the maturation of long-term data for targeted therapies, particularly in chronic conditions where durability and safety are paramount.
BeOne Medicines is contributing significantly to this scientific dialogue, with an extensive presentation schedule highlighting its portfolio and pipeline. The central pillar of BeOne Medical Affairs’ presence is the highly anticipated six-year follow-up data for Zanubrutinib in the treatment-naïve (TN) chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) setting, drawn from the pivotal Phase 3 SEQUOIA trial. This extended analysis offers essential clarity on the sustained clinical profile of Zanubrutinib as a first-line treatment.
The Evolving Standard of Care: Why Six Years Matters in CLL
CLL is characterized by its heterogeneity and its slow-progressing nature, demanding therapeutic strategies that are effective not just for months, but for many years. When selecting a frontline therapy, clinicians must evaluate the agent’s ability to maintain a deep, continuous response while ensuring the patient’s quality of life is preserved, free from disruptive, cumulative toxicities.
The presentation of six-year follow-up data from the SEQUOIA trial directly addresses this long-term management challenge. Moving beyond the initial primary endpoint findings, this analysis provides definitive evidence regarding the therapeutic trajectory of continuous treatment with Zanubrutinib compared to historical chemoimmunotherapy (CIT) benchmarks. For a disease that may require a lifetime of management, this prolonged observation period is foundational for defining the next-generation standard of care.
Assessing Sustained Efficacy and Durability
The analysis of progression-free survival (PFS) at the six-year mark is particularly critical. In the context of the SEQUOIA study, which randomized patients without the del(17p) deletion to receive either Zanubrutinib or bendamustine plus rituximab (BR), the extended follow-up validates the initial finding of sustained superiority of the targeted agent over CIT. This durability is vital, as it offers the promise of continuous disease control, reducing the need for treatment switches or the introduction of salvage therapies. Furthermore, these data contribute to greater confidence in the long-term benefit for patients receiving Zanubrutinib, influencing treatment algorithms globally.
Comprehensive Evaluation of Cumulative Safety
The long-term safety profile of a continuously administered agent is arguably as important as its efficacy. Toxicities that may be uncommon in the initial years can become more prevalent or severe over time due to accumulation. The six-year analysis from SEQUOIA offers a robust opportunity to comprehensively characterize the safety profile of Zanubrutinib across several critical domains, including:
- Cardiac Safety: Monitoring the incidence and severity of cardiac-related adverse events, which is a known class effect of BTK inhibitors, becomes increasingly important over long exposure times, especially in the older CLL patient population that often presents with pre-existing cardiovascular risk factors.
- Infections and Immunosuppression: Evaluating the long-term risk and pattern of infectious complications that can arise from prolonged immunomodulation is crucial.
- Second Primary Malignancies: Analyzing the cumulative incidence of second primary malignancies (SPMs) to ensure the long-term treatment strategy does not introduce undue late-stage risks.
The six-year data ensures that the clinical decision to initiate Zanubrutinib is supported by a thorough understanding of both its long-term benefits and its manageable safety profile, reinforcing its position as a favorable option for TN CLL/SLL.
Addressing High-Risk Subgroups: SEQUOIA Arm C and Combination Strategies
The complexity of CLL necessitates specific data for patients with high-risk genetic features, who often experience rapid progression and poor outcomes with traditional treatments. The BeOne presentations provide important updates on these specific patient groups.
Insights from the del(17p) Cohort
A non-randomized cohort (Arm C) of the SEQUOIA study was specifically dedicated to TN CLL/SLL patients harboring the aggressive del(17p) deletion, which typically dictates a high-risk diagnosis.The presentation of six-year follow-up data for this population is transformative, as it represents one of the largest and longest prospective analyses of a single BTK inhibitor in this difficult-to-treat group. The sustained progression-free survival observed in these patients provides a foundational benchmark against which all future therapies for del(17p)-positive TN CLL/SLL will be measured. The consistency of benefit for these patients is a cornerstone of the BeOne congress activity.
Fixed-Duration Combination Therapy (SEQUOIA Arm D)
Looking ahead, BeOne’s ASH 2025 data presentations also provide updates on combination strategies that could enable a finite, treatment-free interval. Results from SEQUOIA Arm D, evaluating Zanubrutinib in combination with venetoclax in TN CLL/SLL, including those with high-risk mutations, are featured.This research focuses on the ability of the doublet regimen to achieve high rates of undetectable minimal residual disease (uMRD), a necessary prerequisite for stopping therapy. Providing updated results on this combination strategy helps clarify the role of fixed-duration options alongside continuous monotherapy in the frontline setting.
Extending the Evidence: R/R CLL/SLL and Next-Generation Agents
The company’s commitment to durability is not limited to the TN setting. Long-term follow-up from the Phase 3 ALPINE trial in relapsed/refractory (R/R) CLL/SLL is also being presented, with data extending up to six years through the long-term extension phase.These R/R findings complement the SEQUOIA data, providing a holistic view of Zanubrutinib’s long-term performance across different lines of therapy.
Moreover, the pipeline presentations introduce novel mechanisms designed to further improve outcomes and overcome therapeutic resistance:
- Novel BCL2 Inhibition: Updates on the BCL2 inhibitor Sonrotoclax (BGB-11417) highlight its potential as a highly potent agent in various combination settings, aiming for deep responses in CLL and other B-cell malignancies.
- BTK Degradation: Early-phase results for the Bruton tyrosine kinase degrader BGB-16673 are featured.This class of agent represents a highly innovative approach to targeting BTK, potentially offering a therapeutic avenue for patients who have developed resistance or intolerance to conventional BTK inhibitors.
Bridging Trials to Practice: Real-World Evidence and Patient Focus
Rounding out the scientific program is a strong focus on real-world evidence (RWE) and patient-centric outcomes. These studies are vital for ensuring that trial findings are relevant and applicable to the heterogeneous patient populations seen in clinical practice.
The congress resources include RWE studies examining real-world treatment patterns and the use of prognostic biomarkers, addressing logistical and clinical challenges faced in the community setting. Furthermore, research focused on Patient-Reported Outcomes (PROs), such as symptom-based progression-free survival (S-PFS), underscores a commitment to translating objective clinical measures into meaningful improvements in patient quality of life.
The depth and duration of the data presented by BeOne Medicines at ASH 2025, particularly the six-year follow-up from SEQUOIA, provide crucial Hematology Congress insights that are essential for shaping the evidence-based management of CLL/SLL for years to come.
