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