In a nutshell
This study aimed to investigate treatment options for chronic lymphocytic leukemia (CLL).
This study concluded that treatment results from clinical trials may not be seen in a real-life setting and that novel agents can improve outcomes for these patients.
Some background
Traditional treatments for CLL include chemotherapy such as bendamustine (Treanda), fludarabine (Fludara), cyclophosphamide (Cytoxan) and immune system targeted treatments such as rituximab (Rituxan). Ibrutinib (Imbruvica) is a novel targeted for therapy that can be used in treating CLL.
Real-life treatment for CLL may be different from that in clinical trials. Therefore, the best treatment option for CLL still remains unclear.
Methods & findings
This study involved 1494 patients with CLL. Patients were followed for an average of 46.6 months. Therapies used and survival outcomes were analyzed.
Patients were grouped by line of therapy (LOT) at enrollment. The average overall survival (OS) was not reached in LOT1. The average OS in LOT2 was 63 months and for LOT3 was 38 months.
33.5% of patients received treatment with bendamustine and rituximab (BR). 21.4% of patients received fludarabine, cyclophosphamide, and rituximab (FCR) treatment. 18.5% received rituximab alone.
The average event-free survival (EFS; survival without complications from leukemia) was 59 months for the BR group compared to 55 months in the FCR group in LOT1. BR or FCR treatments in LOT1 provided improved EFS by 40% and OS by 33% when compared to other treatments in LOT1.
Ibrutinib treatment provided improved OS in LOT2 (by 72.1%), LOT3 (by 55.9%), and LOT4 (by 42.2%) when compared to other treatments in these LOTs.
The most common side effects across all LOTs were pneumonia in 11.6% of patients and low level of white blood cells with fever in 6.2% of patients.
The bottom line
This study concluded that the advantage of LOT1 FCR over BR seen in clinical trials may not be seen in the community setting. It was also concluded that novel LOT2 agents such as ibrutinib improved outcomes for CLL patients.
The fine print
This study was based on medical records. Relevant information might have been missing.
Published By :
Blood advances
Date :
Apr 14, 2020
