A high proportion of patients with chronic lymphocytic leukemia/small lymphocytic leukemia (CLL/SLL) were unable to continue the fixed dosing schedule of venetoclax-based regimens, according to a retrospective study reported in the Journal of the National Comprehensive Cancer Network.
Nearly half of the patients who were receiving venetoclax plus rituximab or obinutuzumab had to discontinue treatment early. The reason for discontinuation was not included in the report.
The retrospective cohort study evaluated data from 116 patients who received venetoclax as part of their first-line treatment and 145 patients in the relapsed/refractory setting. The data were abstracted from medical and pharmacy claims in the IQVIA PharMetrics Plus database.
The first-line cohort comprised of patients with a median age of 62, 73% were male, and the majority lived in the South or Midwest of the United States. Most patients were commercially or self-insured. In the relapsed/refractory cohort, the median age was 64, 74% of patients were male, and the majority lived in the West or Southern United States.
There were 99.1% of patients treated with venetoclax plus obinutuzumab only in the first-line cohort. The median follow-up was 11.4 months and the median duration of treatment was 12.4 months. There were 46.1% of patients who discontinued treatment and of these patients, there was evidence that 46.7% received subsequent therapy.
In the relapsed/refractory cohort, there were 91.7% of patients who received treatment with venetoclax plus rituximab only. The median follow-up was 15.5 months and the median duration of treatment was 24.5 months. There were 45.1% of patients who discontinued treatment, with 60.4% of these patients receiving subsequent therapy.
A subset of patients in both cohorts were treated beyond the fixed duration, including 25.2% of patients in the first-line cohort and 14.3% of patients in the relapsed/refractory cohort.
“These findings suggest venetoclax-based treatment approaches may not be suitable for all CLL/SLL patients,” the authors concluded in their report. “Future studies are needed with a larger sample, longer follow-up, data on molecular profile, and reasons for treatment discontinuation.”
Disclosures: This study was supported by AstraZeneca Pharmaceuticals. Please see the original reference for a full list of disclosures.
Teschemaker A, Hakre S, Tse J, et al. Real-world duration of venetoclax treatment for chronic lymphocytic leukemia and small lymphocytic leukemia (CLL/SLL). J Natl Compr Cancer Netw. 2023;21:HSR23-119. doi: 10.6004/jnccn.2022.7221