Outcomes for patients with chronic lymphocytic leukemia (CLL) previously treated with both a covalent BTK and BCL2 inhibitor in the United States: A real-world database study Journal Article


Authors: Mato, A. R.; Hess, L. M.; Chen, Y.; Abada, P. B.; Konig, H.; Pagel, J. M.; Walgren, R. A.
Article Title: Outcomes for patients with chronic lymphocytic leukemia (CLL) previously treated with both a covalent BTK and BCL2 inhibitor in the United States: A real-world database study
Abstract: Purpose: This study describes the treatment patterns and outcomes of patients with CLL/SLL in a de-identified real-world oncology electronic health records database. Methods: Adult patients with CLL/SLL were eligible if they had received cBTKi therapy, both a cBTKi and a BCL2i, or all 4 drug classes (cBTKi, BCL2i, rituximab, and chemotherapy) at any time during the first 5 lines of therapy. Time-to-event outcomes were evaluated using Kaplan Meier method. No statistical comparisons were conducted; all analyses were descriptive and conducted using SAS Enterprise. Results: A total of 9578 patients were eligible: 52.0% (n = 4983) received at least one cBTKi, 6.1% (n = 581) received both a cBTKi and BCL2i, and 2.3% (n = 218) received all four therapies (cBTKi, BCL2i, rituximab, and chemotherapy). Of those who discontinued these treatments, only 39.5% (n = 1 206/3 577), 59.7% (n = 228/382), and 55.0% (n = 82/149) received subsequent therapy (post-cBTKi, post-cBTKi/post-BCL2i, and post-all 4 therapies, respectively). Median time from treatment discontinuation of these therapies to the discontinuation of subsequent therapy or death was 9.5 months (all patients who discontinued the cBTKi) 5.6 months (those who discontinued both a cBTKi and BCL2i) and 3.9 months (patients who discontinued all four therapies). The median duration of the next treatment among those who received additional therapy was post-cBTKi treatment duration = 4.1 months; post-cBTKi/post-BCL2i treatment duration = 5.5 months; and median duration of the immediate next therapy after discontinuation of all 4 therapies = 5.1 months. Conclusions: The poor outcomes observed across cohorts in this study demonstrate the need for effective treatments that can improve outcomes in patients with CLL/SLL. © 2022 The Authors
Keywords: adult; controlled study; treatment outcome; aged; major clinical study; cancer combination chemotherapy; drug withdrawal; treatment duration; antineoplastic agents; united states; rituximab; antineoplastic agent; protein bcl 2; retrospective study; phosphatidylinositol 3 kinase; health care quality; kaplan meier method; observational study; chronic lymphatic leukemia; proto-oncogene proteins c-bcl-2; leukemia, lymphocytic, chronic, b-cell; retrospective; ibrutinib; time to treatment; humans; human; male; female; article; obinutuzumab; venetoclax; b-cell malignancies; electronic health record; bcl2 protein, human; acalabrutinib; bruton tyrosine kinase inhibitor; zanubrutinib; covalent btk inhibitor; observational
Journal Title: Clinical Lymphoma, Myeloma and Leukemia
Volume: 23
Issue: 1
ISSN: 2152-2650
Publisher: Elsevier Inc.  
Date Published: 2023-01-01
Start Page: 57
End Page: 67
Language: English
DOI: 10.1016/j.clml.2022.09.007
PUBMED: 36335022
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 3 January 2023 -- Source: Scopus
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  1. Anthony R Mato
    235 Mato