Evaluating population-level outcomes in Chronic Lymphocytic leukemia in the era of novel therapies using the SEER registry.

Autor: Muthiah C; Department of Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, USA., Narra R; Division of Hematology and Oncology, Department of Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, USA., Atallah E; Division of Hematology and Oncology, Medical College of Wisconsin, Cancer Center-Froedtert Hospital, Milwaukee, WI, USA., Juan W; Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, USA., Szabo A; Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, USA., Guru Murthy GS; Division of Hematology and Oncology, Department of Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address: drguru07@gmail.com.
Jazyk: angličtina
Zdroj: Leukemia research [Leuk Res] 2024 May; Vol. 140, pp. 107496. Date of Electronic Publication: 2024 Mar 22.
DOI: 10.1016/j.leukres.2024.107496
Abstrakt: In the last decade, novel agents such as BTK and BCL-2 inhibitors have revolutionized treatment of CLL/SLL, with clinical trials showing improved overall survival compared to chemotherapeutic agents. However, studies examining whether they have improved overall survival at the population level are lacking. We evaluated this by conducting a retrospective analysis of CLL/SLL patients registered in the National Cancer Institute's surveillance epidemiology and end results (SEER) database, analyzing overall survival (OS) in periods pre- and post-availability of novel agents, along with demographic information. Our results showed that median OS significantly improved over time [7.8 years (2000-2005), 9.1 years (2006-2013), and not reached (2014-2018) (p < 0.001)]. Compared to diagnosis in 2014-2018, diagnosis in earlier periods was associated with higher mortality risk (2000-2005-HR 1.32, 95 % CI 1.28-1.37, p < 0.001: 2006-2013-HR 1.09, 95 % CI 1.06-1.13, p < 0.001). Lower mortality risk was seen in patients age < 85 years whereas median household income of <$75000 was associated with higher mortality. Our study provides real-world data suggesting a possible multifactorial contribution to improvement in survival, including availability of novel agents, better monitoring, and supportive care. They also show discrepancies in overall survival for CLL/SLL patients due to socioeconomic status and demographic factors.
Competing Interests: Declaration of Competing Interest Dr. Guru Subramanian Guru Murthy reports the following outside the submitted work - Cardinal Health (Honoraria), BMS (Advisory board), BeiGene (Advisory board), Pfizer (Advisory board), Gilead/Kite (Advisory board), Amgen (Speaker Bureau), Rigel (Speaker Bureau), Cancerexpert now (Consultancy), Qessential (Consultancy), Techspert (Consultancy), DAVA Oncology (Honoraria), Aptitude Health (Honoraria) and Curio science (Honoraria), all outside the submitted work. Dr. Ehab Atallah reports the following outside the submitted work – Abbvie (Speaker Bureau, consultant, research support), Novartis (Consultant, research support), BMS (Speaker Bureau, Consultant), Takeda (Research support), all outside the submitted work. All other authors report no relevant conflict of interest.
(Copyright © 2024 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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