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Outcomes may improve with ibrutinib in chronic lymphocytic leukemia
First-line ibrutinib is associated with better outcomes than chemoimmunotherapy among patients with chronic lymphocytic leukemia (CLL), according to a study published online May 13 in Clinical Lymphoma, Myeloma & Leukemia.
Nilanjan Ghosh, M.D., Ph.D., from the Levine Cancer Institute in Charlotte, North Carolina, and colleagues conducted an observational registry study involving 1,459 CLL patients who were enrolled between October 2015 and June 2019; 854 patients were treated in the first-line setting and 605 in the relapsed/refractory setting.
The most common index treatments were ibrutinib and chemoimmunotherapy. The researchers found that the median time to next treatment (TTNT) was not reached (NR) and was 48.6 months with a median follow-up of 31.8 and 30.9 months in the first-line and relapsed/refractory cohorts, respectively, in patients who received any index treatment; at 48 months, the estimated proportions without next-line therapy were 64 and 50%, respectively. For both cohorts, median overall survival was NR; in the first-line and relapsed/refractory cohorts, the estimated 48-month overall survival rates were 81 and 64%.
TTNT was improved with first-line ibrutinib versus chemoimmunotherapy in match-adjusted analyses (median, NR versus 56.5 months; hazard ratio, 0.74). Lower exposure-adjusted rates of adverse events leading to discontinuation and serious adverse events were seen with ibrutinib versus chemoimmunotherapy. Black and White patients who received any index treatment or ibrutinib had similar estimated 36-month overall survival rates.
"Analysis of outcomes in Black versus White patients suggest that access to novel agents such as ibrutinib may in part overcome historical disparities in clinical outcomes by race in patients with CLL," the authors write.
Several authors disclosed ties to pharmaceutical companies, including AbbVie, which funded the study; Pharmacyclics, an AbbVie Company, which manufactures ibrutinib.
More information: Nilanjan Ghosh et al, Real-World Treatment Patterns and Outcomes by Line of Therapy and Race in Patients With Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma Treated in the United States: Results From the Final Analysis of the Prospective, Observational, informCLL Registry, Clinical Lymphoma Myeloma and Leukemia (2024). DOI: 10.1016/j.clml.2024.05.009
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