Toxicity and Treatment Discontinuation in CLL: U.S. Veterans Health Administration Study
Posted: Tuesday, March 23, 2021
According to research presented in Leukemia & Lymphoma, adverse events may have a significant impact on dose reduction and treatment discontinuation in some patients being treated with novel agents for chronic lymphocytic leukemia (CLL). Zohra Nooruddin, MD, of the South Texas Veterans Healthcare System in San Antonio, and colleagues sought to understand treatment patterns with novel therapies in patients with CLL in the Veterans Healthcare Administration population, which has a high number of risk factors for the disease.
The retrospective chart review included 1,205 patients who had been treated with a novel oral therapy in a Veterans Healthcare Administration setting between October 2013, and March 2018. Eligible treatments included first-line ibrutinib (n = 328), beyond first-line ibrutinib (n = 741), idelalisib (n = 49), or venetoclax (n = 87). Patients were followed for at least 6 months regardless of whether treatment discontinuation occurred.
Treatment discontinuation was most common among the idelalisib group, occurring in 84% of patients treated with this agent (n = 41) overall, 54% of whom discontinued therapy due to adverse events. Among the group given ibrutinib in a later-line setting, treatment was discontinued in 35% (n = 262), 63% of whom did so due to adverse events. The discontinuation rate in the first-line ibrutinib group was 33% (n = 107), with 64% due to adverse events. Finally, the venetoclax group had a discontinuation rate of 31% (n = 27), of whom 41% discontinued therapy due to adverse events.
“The higher rates of dose reductions and discontinuation due to [adverse events] in our study compared to clinical trials may reflect the higher incidence of [adverse events] in routine clinical practice, the complexities of real-world patients, and difficulties of managing both acute and chronic [adverse events] in these older patients,” concluded the study authors.
Disclosure: For full disclosures of the study authors, visit tandfonline.com.
