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Ibrutinib Treatment in CLL: Focus on Disease With and Without Deletion 17p

By: Joshua Swore
Posted: Tuesday, August 23, 2022

According to a study published in Haematologica, patients with deletion 17p chronic lymphocytic leukemia (CLL) have a poor prognosis compared with patients without the deletion. “While [Bruton’s tyrosine kinase] inhibitors are currently considered a standard of care for this patient population in the first-line setting, there is still room for improvement in defining the best approach,” said senior author Jeff P. Sharman, MD, of Willamette Valley Cancer Institute, Eugene, Oregon, and colleagues.

The retrospective study used data acquired from the Flatiron Health electron health record–derived database and included 1,069 patients diagnosed with CLL who received ibrutinib as first-line treatment. The cohort was divided into patients with deletion 17p (n = 254) and those without the deletion (n = 815).

The authors reported that the median overall survival was shorter among the population with deletion 17p at 57.7 months, whereas the median was not reached in patients without the deletion (P = .00006). Similarly, the time to next treatment was also shorter among those with deletion 17p (49 months vs. not reached, P = .0330). Although the time to treatment discontinuation was not significantly different between the two groups, the rate of discontinuation of therapy because of disease progression was higher among patients with deletion 17p. The most common cause of treatment discontinuation within both groups was toxicity. The researchers further analyzed the risk for death, finding that patients with deletion 17p were at higher risk, according to an adjusted Cox proportional hazards model (hazard ratio = 1.70, P = .0031).

“This study identifies an unmet need for more effective first-line therapeutic options in patients with CLL/[small lymphocytic lymphoma] and del(17p), despite the advent of ibrutinib,” the study authors commented.

Disclosure: For full disclosures of study authors, visit haematologica.org.


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