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The first-line treatment of chronic lymphocytic leukemia (CLL) with targeted therapies resulted in an association of longer overall survival (OS) among U.S. military veterans compared with the use of chemotherapy or monoclonal antibodies, according to an analysis of the VA Central Cancer Registry that was presented at the SOHO 2023 Annual Meeting.
The retrospective study analyzed data of U.S. veterans who received first-line treatment for CLL between 1998 and 2020. The main outcome measure was OS from the initiation of first-line therapy. Of the 16,331 veterans in the registry with CLL, 6332 received treatment.
A large shift in treatment patterns was observed between 1998 and 2005 to 2020, in which the use of targeted therapies increased from 0% to 80%. The most commonly used targeted agent was ibrutinib, which represented 93% of targeted therapies used in the registry. Nontargeted agents included chemoimmunotherapy, chemotherapy, and monoclonal antibodies.
OS was longest among patients treated with chemoimmunotherapy, with a median of 6.1 years, followed by targeted therapy with a median of 5.4 years. The median OS was 4.6 years with monoclonal antibodies and 3.6 years with chemotherapy.
Longer OS was significantly associated with first-line use of targeted therapy (hazard ratio [HR], 0.637; 95% CI, 0.543-0.747; P <.0001), chemoimmunotherapy (HR, 0.803; 95% CI, 0.734-0.870; P <.0001), or a monoclonal antibody (HR, 0.835; 95% CI, 0.738-0.946; P =.0044) compared with chemotherapy in a multivariate analysis.
Furthermore, any exposure to a targeted agent was associated with longer OS (HR, 0.424; 95% CI, 0.384-0.468; P <.0001). Older age at diagnosis, however, was associated with shorter survival (HR, 1.042; 95% CI, 1.024-1.061).
Reference
Ma H, O’Brien S, Gupta P. Outcomes of U.S. military veterans with chronic lymphocytic leukemia (CLL) treated with different first‑line treatments from 1998 to 2020. Presented at: the Eleventh Annual Meeting of the Society of Hematologic Oncology (SOHO); September 6-9, 2023. CLL-375.
This article originally appeared on Hematology Advisor
