Real-world analysis of treatment patterns and clinical outcomes in patients with newly diagnosed chronic lymphocytic leukemia from seven Latin American countries.

Autor: Chiattone C; Hematology and Oncology Discipline, Santa Casa Medical School, Sao Paulo, Brazil., Gomez-Almaguer D; Hematology Service, Hospital Universitario 'Dr. José E. González', Monterrey, Mexico., Pavlovsky C; FUNDALEU Hospital and Clinical Research Centre, Buenos Aires, Argentina., Tuna-Aguilar EJ; Hematology and Oncology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico., Basquiera AL; Hematology, Hospital Privado Centro Medico de Cordoba, Cordoba, Argentina., Palmer L; Complejo Medico de la PFA Churruca - Visca, Argentina., de Farias DLC; Hospital das Clinicas da Universidade Federal de Goias, Goiânia, Brazil., da Silva Araujo SS; Hospital das Clínicas - Universidade Federal de Minas Gerais, Brazil., Galvez-Cardenas KM; Hospital Pablo Tobón Uribe, Medellin, Colombia., Gomez Diaz A; Hemato Oncologos S.A., Cali, Colombia., Lin JH; Janssen Scientific Affairs, LLC, Titusville, NJ, USA., Chen YW; Janssen Scientific Affairs, LLC, Titusville, NJ, USA., Machnicki G; Janssen Cilag Farmaceutica SA, Buenos Aires, Argentina., Mahler M; Janssen Global Services, LLC, Raritan, NJ, USA., Parisi L; Janssen Pharmaceutical Companies of Johnson and Johnson, Titusville, NJ, USA., Barreyro P; Janssen Cilag Farmaceutica SA, Buenos Aires, Argentina.
Jazyk: angličtina
Zdroj: Hematology (Amsterdam, Netherlands) [Hematology] 2020 Dec; Vol. 25 (1), pp. 366-371.
DOI: 10.1080/16078454.2020.1833504
Abstrakt: Objective: To describe chronic lymphocytic leukemia (CLL) treatment patterns and patient outcomes in Latin America.
Methods: This chart review study (NCT02559583; 2008-2015)evaluated time to progression (TTP) and overall survival (OS) outcomes among patients with CLL who initiate done ( n  = 261) to two ( n  = 96) lines of therapy (LOT) since diagnosis. Differences in TTP and OS were assessed by Kaplan-Meier analysis, with a log-rank test for statistical significance. Association between therapeutic regimen and risk for disease progression or death was estimated using Cox proportional hazard regression.
Results: The most commonly prescribed therapies in both LOTs were chlorambucil-, followed by fludarabine- and cyclophosphamide (C)/CHOP-based therapies. Chlorambucil- and C/CHOP-based therapies were largely prescribed to elderly patients (≥65 years) while fludarabine-based therapy was predominantly used by younger patients (≤65 years). In LOT1, relative to chlorambucil-administered patients, those prescribed fludarabine-based therapies had lower risk of disease progression (hazard ratio [HR] and 95% confidence interval [CI] 0.32 [0.19-0.54]), whereas C/CHOP-prescribed patients had higher risk (HR 95%CI 1.88 [1.17-3.04]). Similar results were observed in LOT2. There was no difference in OS between treatments in both LOTs.
Discussion: Novel therapies such as kinase inhibitors were rarely prescribed in LOT1 or LOT2in Latin America. The greater TTP observed forfludarabine-based therapies could be attributed to the fact that fludarabine-based therapies are predominantly administered to young and healthy patients.
Conclusion: Chlorambucil-based therapy, which has limited benefits, is frequently prescribed in Latin America. Prescribing novel agents for fludarabine-based therapy-ineligible patients with CLL is the need of the hour. Trial registration: ClinicalTrials.gov identifier: NCT02559583.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje