Comparison of real-world treatment patterns in chronic lymphocytic leukemia management before and after availability of ibrutinib in the province of British Columbia, Canada

Autor: Alina S. Gerrie, Monica Hrynchak, Tracy Tucker, Cynthia L. Toze, Sean D. Young, Peter Tsang, Abdulwahab J. Al Tourah, Laurie H. Sehn, Gregory Dueck, Edward Hardy, Paul F. Galbraith, Helene Bruyere, Michael C. Noble, Steven J.T. Huang, Khaled M. Ramadan
Rok vydání: 2019
Předmět:
Male
Cancer Research
Neoplasm
Residual
17p deletion
Chronic lymphocytic leukemia
medicine.medical_treatment
chemistry.chemical_compound
0302 clinical medicine
Piperidines
Recurrence
Antineoplastic Combined Chemotherapy Protocols
Medicine
Aged
80 and over
education.field_of_study
Remission Induction
Hematopoietic Stem Cell Transplantation
Disease Management
Hematology
Middle Aged
Prognosis
Treatment Outcome
Oncology
Vincristine
030220 oncology & carcinogenesis
Ibrutinib
Female
Chromosome Deletion
Rituximab
Vidarabine
Adult
medicine.medical_specialty
Population
03 medical and health sciences
Chemoimmunotherapy
Internal medicine
Overall survival
Humans
Transplantation
Homologous
education
Cyclophosphamide
Aged
Retrospective Studies
Chemotherapy
British Columbia
business.industry
Adenine
Retrospective cohort study
medicine.disease
Leukemia
Lymphocytic
Chronic
B-Cell
Survival Analysis
Pyrimidines
chemistry
Doxorubicin
Prednisone
Pyrazoles
Smith-Magenis Syndrome
business
030215 immunology
Chromosomes
Human
Pair 17
Zdroj: Leukemia research. 91
ISSN: 1873-5835
Popis: We performed a retrospective study comparing treatment patterns and overall survival (OS) in chronic lymphocytic leukemia (CLL) patients with the advent of ibrutinib to provide current real-world data.Using a provincial population-based database, we analyzed CLL patients who received upfront treatment in British Columbia before ibrutinib availability (1984-2014), during ibrutinib access for: relapse only (2014-2015) and for upfront treatment of patients (with 17p deletion or unfit for chemotherapy) (2015-2016). Analysis included up to third-line treatment.Of 1729 patients meeting inclusion criteria (median age, 66 years; 1466, period 1; 140, period 2; 123, period 3), FR was the most common first-line therapy (35.8 %, 54.3 % and 40.7 %, periods 1-3, respectively) and 18.7 % received ibrutinib upfront in period 3. The most common therapies in relapse were chemoimmunotherapy (36.1 % and 55.6 %, periods 1 and 2, second-line; 29.2 %, period 1, third-line) and ibrutinib (69.8 %, period 3, second-line; 46.4 % and 70.3 %, periods 2 and 3, third-line). OS improved for patients treated in periods 2-3 over period 1 (median OS not reached vs. 11.9 years, p 0.001; no difference in OS for periods 2-3, p = 0.385).Ibrutinib has replaced chemoimmunotherapy as the preferred therapy in relapse. Overall survival has improved over time with access to ibrutinib.
Databáze: OpenAIRE
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