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Real-World Outcomes by Race in Patients with Chronic Lymphocytic Leukemia in the informCLL Registry Study
A recent study analyzed the real-world treatment patterns and outcomes by race and line of therapy (LOT) in patients with CLL/SLL who began treatment after the US Food and Drug Administration (FDA) approved ibrutinib. Jacqueline Claudia Barrientos, MD, Mount Sinai Comprehensive Cancer Center, Miami Beach, FL, and colleagues presented their findings from the informCLL clinical trial at the 2023 ASCO Annual Meeting in Chicago, IL.
The informCLL registry tracked the treatment patterns of patients with CLL/SLL who had initiated treatment with FDA-approved oral kinase inhibitors, including ibrutinib. In total, 1,459 patients participated in the study and were enrolled between October 2015 and June 2019: 105 were Black, with 58 in first-line (1L) treatment and 47 in relapsed/refractory (R/R) status; 1,323 were White, with 779 in 1L treatment and 544 in R/R status; and 31 were of other races.
The study found that when compared to White patients, Black patients who received 1L treatment were younger (median age 65 vs 70 years old) and had worse Eastern Cooperative Oncology Group [ECOG] performance status ( ≥1: 59% vs 50%); higher Rai staging (III-IV: 55% vs 46%), indicating more advanced disease; shorter time from diagnosis to 1L treatment (median 7 vs 19 months); and lower rates of deletion 17p among tested patients (6% vs 13%).
For Black and White patients, ibrutinib was the most common treatment (n = 29 [50%] and n = 346 [44%], respectively); chemoimmunotherapy was the next most common treatment for both patient groups (Black, n = 25 [43%]; White, n = 331 [42%]). The estimated 36-month overall survival (OS) rates in all treated patients were also similar by race, with Black patients treated with ibrutinib having an OS of 97% at 36 months.
The researchers also completed a multivariate analysis (MVA) and determined that for all 1L patients, the independent predictors of decreased OS were being male, having poorer ECOG status, and having an increased comorbidity burden; race was not associated with OS. In the MVA for 1L patients who had been treated with ibrutinib, only longer time from diagnosis to 1L treatment was associated with decreased OS. Rates of serious adverse events (AEs) were 28% for all treated Black patients, 29% for all treated White patients, 45% for Black patients treated with ibrutinib, and 38% for White patients treated with ibrutinib. AEs leading to treatment discontinuation were also similar across race (14% and 25% for all treated Black and White patients, respectively; 24% and 36% for ibrutinib-treated Black and White patients, respectively).
“Although historical retrospective studies from the pre-novel agent era have shown poorer clinical outcomes among Black patients with CLL relative to non-Black patients, results from informCLL show similar or potentially improved outcomes, including OS, among 1L ibrutinib-treated Black patients relative to White patients,” said the authors.
Dr Barrientos and colleagues suggest that providing more access to novel agent treatment options, such as ibrutinib, may help in overcoming historical disparities in clinical outcomes by race in patients with CLL.
Source:
Barrientos JC, Sharman JP, Gutierrez ME, et al. Real-world outcomes by race in patients (pts) with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL): Final analysis results from the informCLL registry. Presented at: the 2023 ASCO Annual Meeting; June 2-6, 2023; Chicago, IL, and virtual; Abstract 7536.
