Chronic Lymphocytic Leukemia Coverage from Every Angle

Early Discontinuation of First-Line Ibrutinib in CLL in the Real-World Setting

By: Cordi Craig
Posted: Wednesday, February 5, 2020

Although the Bruton’s tyrosine kinase ibrutinib has been increasingly used in the first-line setting for chronic lymphocytic leukemia (CLL), early discontinuation of this agent appears to be more common in real-world cases than is reported in clinical trials. Scott F. Huntington, MD, MPH, of Yale University, New Haven, Connecticut, and colleagues stated that both older age and worse performance status seemed to be significantly associated with increased odds of early treatment discontinuation. The retrospective cohort study was presented at the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 797) and published in Blood.

Using the Flatiron Health database, the research team identified 5,634 individuals undergoing first-line treatment for CLL at community oncology practices across 280 cancer clinics in the United States between March 2014 and February 2019. Of those patients, 1,639 patients (29.1%) received an ibrutinib-based regimen. 

The number of patients using ibrutinib-based treatments in the first-line setting increased over time, eventually making up about 40% of first-line CLL treatments by late 2018. Adequate follow-up was available for 1,497 patients. Of those patients, 16.2% discontinued treatment early. Early treatment discontinuation was more common among older patients (at least age 80; P < .001), those who required treatment within the first year of CLL diagnosis, and those with an Eastern Cooperative Oncology Group performance status greater than 2 (P < .001).

“Given the complexity of the rapidly changing CLL treatment landscape, clinical decision support tools and other modern cancer care delivery approaches should be explored to improve administration of novel CLL therapies in the real-world setting,” the research team concluded.

Disclosure: For full disclosures of the study authors, visit

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