Fixed-duration venetoclax plus obinutuzumab improves quality of life and geriatric impairments in FCR-unfit patients with CLL.

Autor:	van der Straten L; Department of Immunology, Erasmus MC, Rotterdam, The Netherlands.; Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands.; Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands., Stege CAM; Department of Hematology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam-Treatment and Quality of Life, Amsterdam, The Netherlands., Kersting S; Department of Hematology, HAGA Teaching Hospital, The Hague, The Netherlands., Nasserinejad K; Department of Hematology, HOVON Data Center, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., Dubois J; Department of Hematology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Lymphoma and Myeloma Center Amsterdam, Amsterdam, The Netherlands., Dobber JA; Department of Laboratory Special Hematology, Amsterdam University Medical Center, Amsterdam, The Netherlands., Mellink CHM; Department of Human Genetics, Section Cytogenetics, Amsterdam University Medical Center, Amsterdam, The Netherlands., van der Kevie-Kersemaekers AF; Department of Human Genetics, Section Cytogenetics, Amsterdam University Medical Center, Amsterdam, The Netherlands., Evers LM; Department of Laboratory Special Hematology, Amsterdam University Medical Center, Amsterdam, The Netherlands., de Boer F; Department of Internal Medicine, Ikazia Hospital, Rotterdam, The Netherlands., Koene HR; Department of Hematology, Antonius Hospital, Nieuwegein, The Netherlands., Schreurs J; Department of Internal Medicine, Martini Hospital, Groningen, The Netherlands., van der Klift M; Department of Internal Medicine, Amphia Hospital, Breda, The Netherlands., Velders GA; Department of Internal Medicine, Gelderland Valley Hospital, Ede, The Netherlands., van der Spek E; Department of Internal Medicine, Rijnstate Hospital, Arnhem, The Netherlands., van der Straaten HM; Department of Internal Medicine, St Jansdal Hospital, Harderwijk, The Netherlands., Hoogendoorn M; Department of Internal Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands., van Gelder M; Department of Hematology, Maastricht University Medical Center, Maastricht, The Netherlands., Posthuma EFM; Department of Internal Medicine, Reinier The Graaf Hospital, Delft, The Netherlands.; Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands., Visser HPJ; Department of Internal Medicine, Northwest Clinics, Alkmaar, The Netherlands., Houtenbos I; Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, The Netherlands., Idink CAM; Department of Internal Medicine, ZorgSaam Hospital, Terneuzen, The Netherlands., Issa DE; Department of Internal Medicine, Jeroen Bosch Hospital, s-Hertogenbosch, The Netherlands., Dompeling EC; Department of Hematology, Isala Hospital, Zwolle, The Netherlands., van Zaanen HCT; Department of Internal Medicine, St Franciscus Hospital, Rotterdam, The Netherlands., Veelken JH; Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands., Levenga H; Department of Internal Medicine, Groene Hart Hospital, Gouda, The Netherlands., Tick LW; Department of Internal Medicine, Maxima Medical Center, Eindhoven, The Netherlands., Terpstra WE; Department of Internal Medicine, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands., Tonino SH; Department of Hematology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Lymphoma and Myeloma Center Amsterdam, Amsterdam, The Netherlands., Westerweel PE; Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands., Langerak AW; Department of Immunology, Erasmus MC, Rotterdam, The Netherlands., Kater AP; Department of Hematology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Lymphoma and Myeloma Center Amsterdam, Amsterdam, The Netherlands., Levin MD; Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
Jazyk:	angličtina
Zdroj:	Blood [Blood] 2023 Sep 28; Vol. 142 (13), pp. 1131-1142.
DOI:	10.1182/blood.2023020195
Abstrakt:	Chronic lymphocytic leukemia (CLL)-related symptoms and morbidity related to the advanced age at diagnosis impairs the well-being of older adult patients. Therefore, it is essential to tailor treatment according to geriatric characteristics and aim for an improvement in health-related quality of life (HRQoL) as a primary treatment goal. In the HOVON139/GiVe trial, 12 cycles of fixed-duration venetoclax plus obinutuzumab (Ven-O) were shown to be effective and tolerable in FCR (fludarabine, cyclophosphamide, rituximab)-unfit patients with CLL (n = 67). However, prolonged venetoclax exposure as consolidation treatment led to increased toxicity with limited effect on minimal residual disease. To assess the impact of geriatric assessment on treatment outcomes and the patients' HRQoL, patient-reported outcomes (PROs), including function, depression, cognition, nutrition, physical performance, muscle parameters, comorbidities, and the European Organization for Research and Treatment of Cancer C30 and CLL17 questionnaires were assessed. At baseline, geriatric impairments were present in >90% of patients and ≥2 impairments present in 60% of patients predicted grade ≥3 nonhematological toxicity. During treatment, the number of geriatric impairments diminished significantly and clinically relevant improvements in HRQoL subscales were reached for global health status, physical functioning, role functioning, emotional functioning, fatigue, dyspnea, physical condition or fatigue, and worries or fears related to health and functioning. These improvements were comparable for patients receiving venetoclax consolidation and patients in whom treatment could mostly be discontinued. Collectively, frontline fixed-duration Ven-O improves overall PROs in older, unfit patients with CLL with and without geriatric impairments. This study was registered at EudraCT as 2015-004985-27 and the Netherlands Trial Register as NTR6043. (© 2023 by The American Society of Hematology.)
Databáze:	MEDLINE
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