Cytogenetic Molecular Risk Testing Can Optimize Outcomes and Costs for Patients With CLL, SLL

Assessing cytogenic/molecular risk status in patients with chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) before choosing a first-line treatment option can improve patient outcomes and reduce costs of care, new research suggests.

Researchers presented data at the 2021 American Society of Clinical Oncology meeting from a retrospective cohort study in which they compared real-world clinical and economic outcomes for patients with CLL/SLL determined to be high or low risk who were starting first-line chemoimmunotherapy.

Using the HealthCore Integrated Research Database, researchers gathered data for 1808 patients with CLL/SLL, of which 612 were assigned risk status by fluorescence in situ hybridization (FISH) or IGHV testing. Eligible participants initiated first-line chemoimmunotherapy between early 2007 and mid 2019. 

High-risk participants had 65% higher risk of both death (median 2.4 years vs 3.7) and treatment failure (median 3 years vs 4.9) compared to patients determined to be low-risk by FISH testing only. High-risk patients also incurred significantly higher costs per person per month during the first-line period at $12,194, compared to $9055 for low-risk participants.

Researchers also found that testing rates increased throughout the study period.

“Assessment of cytogenetic/molecular risk status for appropriate treatment is vital to optimize clinical and economic outcomes, especially in the novel agent era,” researchers noted. “Recent testing practices to assess genetic risk in CLL remains suboptimal.”

Reference:
Leslie LA, Gangan N, Tan H, Huang Q. Clinical and economic burden among patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) receiving first-line (1L) chemoimmunotherapy (CIT) by risk status: A chart-linked claims analysis. J Clin Oncol. 2021;39(15_suppl):e19505-e19505. doi:10.1200/jco.2021.39.15_suppl.e19505