BACKGROUND: Most patients with chronic lymphocytic leukemia (CLL) present with multiple comorbidities. Although comorbidities negatively affect outcomes for patients treated with chemoimmunotherapy, their impact on patients who receive targeted therapies is unknown. METHODS: This multicenter, retrospective analysis evaluated the significance of comorbidities, as assessed by the Cumulative Illness Rating Scale (CIRS), among patients with CLL treated with ibrutinib. RESULTS: One hundred forty-five patients received ibrutinib (80% in a relapsed/refractory setting). A high burden of comorbidities (CIRS score ≥ 7) was associated with inferior median event-free survival (EFS; 24 vs 37 months; P = .003) and 2-year overall survival (OS; 79% vs 100%; P = .005). In an adjusted Cox model, both EFS and OS worsened with an incremental increase in the CIRS score. Furthermore, comorbidities were associated with an increased risk of ibrutinib dose reduction and therapy discontinuation. CIRS was predictive in both frontline and relapsed CLL, regardless of patient age. CONCLUSIONS: Comorbidities portend a poor prognosis among patients with CLL treated with ibrutinib. Prospective studies are needed to optimize the treatment of patients with CLL who have comorbidities. Cancer 2018.
BACKGROUND: Most patients with chronic lymphocytic leukemia (CLL) present with multiple comorbidities. Although comorbidities negatively affect outcomes for patients treated with chemoimmunotherapy, their impact on patients who receive targeted therapies is unknown. METHODS: This multicenter, retrospective analysis evaluated the significance of comorbidities, as assessed by the Cumulative Illness Rating Scale (CIRS), among patients with CLL treated with ibrutinib. RESULTS: One hundred forty-five patients received ibrutinib (80% in a relapsed/refractory setting). A high burden of comorbidities (CIRS score ≥ 7) was associated with inferior median event-free survival (EFS; 24 vs 37 months; P = .003) and 2-year overall survival (OS; 79% vs 100%; P = .005). In an adjusted Cox model, both EFS and OS worsened with an incremental increase in the CIRS score. Furthermore, comorbidities were associated with an increased risk of ibrutinib dose reduction and therapy discontinuation. CIRS was predictive in both frontline and relapsed CLL, regardless of patient age. CONCLUSIONS: Comorbidities portend a poor prognosis among patients with CLL treated with ibrutinib. Prospective studies are needed to optimize the treatment of patients with CLL who have comorbidities. Cancer 2018.
Authors: Max J Gordon; Andy Kaempf; Byung Park; Alexey V Danilov; Andrea Sitlinger; Geoffrey Shouse; Matthew Mei; Danielle M Brander; Tareq Salous; Brian T Hill; Hamood Alqahtani; Michael Choi; Michael C Churnetski; Jonathon B Cohen; Deborah M Stephens; Tanya Siddiqi; Xavier Rivera; Daniel Persky; Paul Wisniewski; Krish Patel; Mazyar Shadman Journal: Clin Cancer Res Date: 2021-06-24 Impact factor: 12.531
Authors: Anthony R Mato; Nilanjan Ghosh; Stephen J Schuster; Nicole Lamanna; John M Pagel; Ian W Flinn; Jacqueline C Barrientos; Kanti R Rai; James A Reeves; Bruce D Cheson; Paul M Barr; Suman Kambhampati; Frederick Lansigan; Jeffrey J Pu; Alan P Skarbnik; Lindsey Roeker; Gustavo A Fonseca; Andrea Sitlinger; Issam S Hamadeh; Colleen Dorsey; Nicole LaRatta; Hanna Weissbrot; Eline T Luning Prak; Patricia Tsao; Dana Paskalis; Peter Sportelli; Hari P Miskin; Michael S Weiss; Jakub Svoboda; Danielle M Brander Journal: Blood Date: 2021-05-20 Impact factor: 22.113
Authors: Alexey V Danilov; Stephen E Spurgeon; Tanya Siddiqi; Anne-Marie Quinson; Daniela Maier; Dionne Smith; Jennifer R Brown Journal: Invest New Drugs Date: 2021-03-08 Impact factor: 3.850