Steven J Huang1, Alina S Gerrie2, Sean Young3, Tracy Tucker3, Helene Bruyere4, Monica Hrynchak5, Paul Galbraith6, Abdulwahab J Al Tourah7, Gregory Dueck8, Michael C Noble9, Khaled M Ramadan10, Peter Tsang11, Edward Hardy12, Laurie Sehn13, Cynthia L Toze14. 1. Division of Hematology, Vancouver General Hospital, University of British Columbia, Canada. 2. Division of Hematology, Vancouver General Hospital, University of British Columbia, Canada; British Columbia Cancer - Vancouver, University of British Columbia, Vancouver, British Columbia, Canada. 3. Pathology and Laboratory Medicine, British Columbia Cancer, University of British Columbia, Vancouver, British Columbia, Canada. 4. Division of Pathology and Laboratory Medicine, Cytogenetics Laboratory, Vancouver General Hospital, University of British Columbia, Canada. 5. Molecular Cytogenetic Laboratory, Royal Columbian Hospital, University of British Columbia, New Westminster, British Columbia, Canada. 6. British Columbia Cancer - Abbotsford, University of British Columbia, Abbotsford, British Columbia, Canada. 7. British Columbia Cancer - Surrey, University of British Columbia, Surrey, British Columbia, Canada. 8. British Columbia Cancer - Kelowna, University of British Columbia, Kelowna, British Columbia, Canada. 9. Royal Columbian Hospital, New Westminster, British Columbia, Canada. 10. St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. 11. Division of Hematology, Vancouver General Hospital, University of British Columbia, Canada; Richmond Hospital, Richmond, British Columbia, Canada. 12. Tom McMurty & Peter Baerg Cancer Centre, Vernon Jubilee Hospital, Vernon, British Columbia, Canada. 13. British Columbia Cancer - Vancouver, University of British Columbia, Vancouver, British Columbia, Canada. 14. Division of Hematology, Vancouver General Hospital, University of British Columbia, Canada; British Columbia Cancer - Vancouver, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: ctoze@bccancer.bc.ca.
Abstract
We performed a retrospective study comparing treatment patterns and overall survival (OS) in chronic lymphocytic leukemia (CLL) patients with the advent of ibrutinib to provide current real-world data. METHODS: Using a provincial population-based database, we analyzed CLL patients who received upfront treatment in British Columbia before ibrutinib availability (1984-2014), during ibrutinib access for: relapse only (2014-2015) and for upfront treatment of patients (with 17p deletion or unfit for chemotherapy) (2015-2016). Analysis included up to third-line treatment. RESULTS: Of 1729 patients meeting inclusion criteria (median age, 66 years; 1466, period 1; 140, period 2; 123, period 3), FR was the most common first-line therapy (35.8 %, 54.3 % and 40.7 %, periods 1-3, respectively) and 18.7 % received ibrutinib upfront in period 3. The most common therapies in relapse were chemoimmunotherapy (36.1 % and 55.6 %, periods 1 and 2, second-line; 29.2 %, period 1, third-line) and ibrutinib (69.8 %, period 3, second-line; 46.4 % and 70.3 %, periods 2 and 3, third-line). OS improved for patients treated in periods 2-3 over period 1 (median OS not reached vs. 11.9 years, p < 0.001; no difference in OS for periods 2-3, p = 0.385). CONCLUSION: Ibrutinib has replaced chemoimmunotherapy as the preferred therapy in relapse. Overall survival has improved over time with access to ibrutinib.
We performed a retrospective study comparing treatment patterns and overall survival (OS) in chronic lymphocytic leukemia (CLL) patients with the advent of ibrutinib to provide current real-world data. METHODS: Using a provincial population-based database, we analyzed CLLpatients who received upfront treatment in British Columbia before ibrutinib availability (1984-2014), during ibrutinib access for: relapse only (2014-2015) and for upfront treatment of patients (with 17p deletion or unfit for chemotherapy) (2015-2016). Analysis included up to third-line treatment. RESULTS: Of 1729 patients meeting inclusion criteria (median age, 66 years; 1466, period 1; 140, period 2; 123, period 3), FR was the most common first-line therapy (35.8 %, 54.3 % and 40.7 %, periods 1-3, respectively) and 18.7 % received ibrutinib upfront in period 3. The most common therapies in relapse were chemoimmunotherapy (36.1 % and 55.6 %, periods 1 and 2, second-line; 29.2 %, period 1, third-line) and ibrutinib (69.8 %, period 3, second-line; 46.4 % and 70.3 %, periods 2 and 3, third-line). OS improved for patients treated in periods 2-3 over period 1 (median OS not reached vs. 11.9 years, p < 0.001; no difference in OS for periods 2-3, p = 0.385). CONCLUSION:Ibrutinib has replaced chemoimmunotherapy as the preferred therapy in relapse. Overall survival has improved over time with access to ibrutinib.
Authors: Soo Jin Seung; Manjusha Hurry; Shazia Hassan; Ashlie Elnoursi; Krystin A B Scheider; Dennis Wagner; Jonathan J Edwin; Andrew T W Aw Journal: Curr Oncol Date: 2021-11-19 Impact factor: 3.677