Racial, age, and sex disparities in chronic lymphocytic leukemia (CLL) patients treated with novel therapies.

Authors

null

Meghan Thompson

Hospital of the University of Pennsylvania, Philadelphia, PA

Meghan Thompson , Chadi Nabhan , Bruce D. Cheson , John Nathan Allan , Paul M. Barr , Alan P. Skarbnik , Ryan Jacobs , Chaitra Shankar Ujjani , Richard R. Furman , Stephen J. Schuster , Nirav Niranjan Shah , John M. Pagel , Danielle M. Brander , Mazyar Shadman , Clive Zent , Nicole Lamanna , Hande H. Tuncer , Frederick Lansigan , Anthony R. Mato , Brian Thomas Hill

Organizations

Hospital of the University of Pennsylvania, Philadelphia, PA, Cardinal Health Specialty Solutions, Dublin, OH, Georgetown University Hospital, Lombardi Comprehensive Cancer Center, Washington, DC, New York Presbyterian Hospital, New York, NY, University of Rochester Medical Center, Rochester, NY, City of Hope, New York, NY, Univ of Texas MD Anderson Cancer Ctr, Houston, TX, Georgetown University Hospital, Lombardi Comprehensive Cancer, Washington, DC, Weill Cornell Medical College, New York, NY, Abramson Cancer Center, Philadelphia, PA, Medical College of Wisconsin, Milwaukee, WI, Swedish Cancer Institute, Seattle, WA, Duke University School of Medicine, Durham, NC, Univ of Washington, Bellevue, WA, New York-Presbyterian, Columbia University Medical Center, Manhasset, NY, Tufts Medical Center, Boston, MA, Dartmouth-Hitchcock Medical Center, Lebanon, NH, Memorial Sloan Kettering Cancer Center, New York, NY, Cleveland Clinic Foundation, Cleveland, OH

Research Funding

Other

Background: Differences in outcomes have been reported in CLL pts receiving chemo±immunotherapy with non-Caucasians and males having inferior outcomes. Less is known if such disparities exist for pts receiving targeted therapies. We investigated how demographics impact outcomes of CLL pts treated with targeted agents. Methods: We analyzed 3 multicenter, retrospective cohort studies of CLL pts treated with ibrutinib (ibr) (front-line (F/L) or relapsed/refractory (R/R) disease) or venetoclax (ven) (R/R disease). Baseline demographics, responses (ORR), discontinuations (DC), progression-free survival (PFS), and overall survival (OS) were stratified by age ( < 65 vs ≥65 yr), sex (male (M) vs female (F)) and race (Caucasian vs other). Cox regression was used for comparisons. Results: 1068 pts were included: F/L ibr (n = 391), R/R ibr (n = 536), R/R ven (n = 141). F/L ibr pts were 38% F, 59% age ≥65 and 8% non-Caucasian. R/R ibr pts were 37% age ≥65 (sex / race data unavailable). R/R ven pts were 34% F, 63% age ≥65 and 13% non-Caucasian. Del17p was similar within all cohorts. AEs were the most common discontinuation (DC) reason in all ibr groups, while CLL progression was most common in ven pts. A higher proportion of M discontinued ven vs F (34% vs 17%). Table 1 includes ORR, PFS, OS and DC stratified by age, sex and race. Conclusions: In the largest series of pts treated with novel agents, we did not find differences in outcomes when stratified by age, sex and race. These data suggest ibr and ven may in part overcome traditional disparities.

AGE: < 65 vs ≥ 65 years
Sex: M vs F
Race: Caucasian vs other
Ibr (F/L)Ibr (R/R)Ven (R/R)Ibr (F/L)Ibr (R/R)Ven (R/R)Ibr (F/L)Ibr (R/R)Ven (R/R)
ORR85% vs 79%67% vs 69%68% vs 74%80% vs 84%NA68% vs 81%83% vs 79%NA71% vs 81%
PFS
(HR for ≥ 65 years, F and other race as events)
HR 1.1 (0.6-2.0), p = 0.7HR 0.9 (0.6-1.2), p = 0.3HR 0.6 (0.3-1.3), p = 0.2HR 0.9 (0.5-1.6), p = 0.7NAHR 0.7 (0.3-1.7), p = 0.4HR 1.9 (0.7-4.8), p = 0.2NAHR 0.3 (0.03-1.9), p = 0.2
OSHR 2.2 (0.9-5.5), p = 0.1HR 1.4 (0.9-2.1), p = 0.1HR 0.9 (0.3-2.5), p = 0.8HR 0.5 (0.2-1.3), p = 0.1NAHR 0.8 (0.3-2.6), p = 0.7HR
1.4 (0.3-5.9), p = 0.7
NANo deaths in Non-Caucasians
DC22% vs 25%44% vs 47%28% vs 28%24% vs 24%NA34% vs 17%NANANA

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2018 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Health Services Research, Clinical Informatics, and Quality of Care

Track

Quality Care/Health Services Research

Sub Track

Outcomes

Citation

J Clin Oncol 36, 2018 (suppl; abstr 6577)

DOI

10.1200/JCO.2018.36.15_suppl.6577

Abstract #

6577

Poster Bd #

402

Abstract Disclosures

Similar Abstracts

First Author: Adam Kittai

First Author: Arya Mariam Roy

Abstract

2023 ASCO Annual Meeting

A study of frontline therapy in adults >80 years with chronic lymphocytic leukemia (CLL).

First Author: Mazie Tsang