Treatment Discontinuation Patterns for Patients With Chronic Lymphocytic Leukemia in Real-World Settings: Results From a Multi-Center International Study. Academic Article uri icon

Overview

abstract

  • INTRODUCTION: This study assessed treatment discontinuation patterns and reasons among chronic lymphocytic leukemia (CLL) patients initiating first-line (1L) and second-line (2L) treatments in real-world settings. MATERIALS AND METHODS: Using deidentified electronic medical records from the CLL Collaborative Study of Real-World Evidence, premature treatment discontinuation was assessed among FCR, BR, BTKi-based, and BCL-2-based regimen cohorts. RESULTS: Of 1364 1L patients (initiated in 1997-2021), 190/13.9% received FCR (23.7% discontinued prematurely); 255/18.7% received BR (34.5% discontinued prematurely); 473/34.7% received BTKi-based regimens, of whom 28.1% discontinued prematurely; and 43/3.2% received venetoclax-based regimens, of whom 16.3% discontinued prematurely (venetoclax monotherapy: 7/0.5%, of whom 42.9% discontinued; VG/VR: 36/2.6%, of whom 11.1% discontinued). The most common reasons for treatment discontinuation were adverse events (FCR: 25/13.2%; BR: 36/14.1%; BTKi-based regimens: 75/15.9%) and disease progression (venetoclax-based: 3/7.0%). Of 626 2L patients, 20/3.2% received FCR (50.0% discontinued); 62/9.9% received BR (35.5% discontinued); 303/48.4% received BTKi-based regimens, of whom 38.0% discontinued; and 73/11.7% received venetoclax-based regimens, of whom 30.1% discontinued (venetoclax monotherapy: 27/4.3%, of whom 29.6% discontinued; VG/VR: 43/6.9%, of whom 27.9% discontinued). The most common reasons for treatment discontinuation were adverse events (FCR: 6/30.0%; BR: 11/17.7%; BTKi-based regimens: 60/19.8%; venetoclax-based: 6/8.2%). CONCLUSION: The findings of this study highlight the continued need for tolerable therapies in CLL, with finite therapy offering a better tolerated option for patients who are newly diagnosed or relapsed/refractory to prior treatments.

authors

  • Shadman, Mazyar
  • Manzoor, Beenish S
  • Sail, Kavita
  • Tuncer, Hande H
  • Allan, John
  • Ujjani, Chaitra
  • Emechebe, Nnadozie
  • Kamalakar, Rajesh
  • Coombs, Catherine C
  • Leslie, Lori
  • Barr, Paul M
  • Brown, Jennifer R
  • Eyre, Toby A
  • Rampotas, Alexandros
  • Schuh, Anna
  • Lamanna, Nicole
  • Skarbnik, Alan
  • Roeker, Lindsey E
  • Bannerji, Rajat
  • Eichhorst, Barbara
  • Fleury, Isabelle
  • Davids, Matthew S
  • Alhasani, Hasan
  • Jiang, Dingfeng
  • Hill, Brian T
  • Schuster, Stephen J
  • Brander, Danielle M
  • Pivneva, Irina
  • Burne, Rebecca
  • Guerin, Annie
  • Mato, Anthony R

publication date

  • March 24, 2023

Research

keywords

  • Antineoplastic Agents
  • Leukemia, Lymphocytic, Chronic, B-Cell

Identity

Scopus Document Identifier

  • 85153074408

Digital Object Identifier (DOI)

  • 10.1016/j.clml.2023.03.010

PubMed ID

  • 37076367

Additional Document Info

volume

  • 23

issue

  • 7