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The Impact of Age on Survival in CLL Patients Receiving Ibrutinib as Initial Therapy

Authors
  • Ujjani, Chaitra1
  • Mato, Anthony2
  • Hill, Brian T3
  • Allan, John N4
  • Lansigan, Frederick5
  • Jacobs, Ryan6
  • Skarbnik, Alan7
  • Tuncer, Hande8
  • Pagel, John9
  • Brander, Danielle10
  • Cheson, Bruce11
  • Barr, Paul12
  • Roeker, Lindsey E2
  • Pu, Jeffrey13
  • Shah, Nirav N14
  • Goy, Andre15
  • Schuster, Stephen J16
  • Lamanna, Nicole17
  • Sehgal, Alison18
  • Tam, Constantine S19
  • And 1 more
  • 1 Seattle Cancer Care Alliance, Fred Hutchinson Cancer Research Center, Seattle, WA
  • 2 Memorial Sloan Kettering Cancer Center, New York, NY
  • 3 Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
  • 4 New York Presbyterian & Weill Cornell, New York, NY
  • 5 Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH
  • 6 Levine Cancer Institute, Charlotte, NC
  • 7 Novant Health Cancer Institute, Charlotte, NC, 28204
  • 8 Lowell General Hospital, Tufts Medical Center, Boston, MA
  • 9 Center for Blood Disorders and Stem Cell Transplantation, Swedish Cancer Institute, Seattle, WA
  • 10 Duke University, Durham, NC
  • 11 Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC
  • 12 Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY
  • 13 SUNY Upstate Medical University, Syracuse, NY
  • 14 Medical College of Wisconsin, Milwaukee, WI
  • 15 John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ
  • 16 Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
  • 17 Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY
  • 18 University of Pittsburgh Medical Center, Pittsburgh, PA
  • 19 Peter McCallum Cancer Centre, University of Melbourne, East Melbourne, VI , (Australia)
Type
Published Article
Journal
Blood and Lymphatic Cancer: Targets and Therapy
Publisher
Dove
Publication Date
Aug 24, 2020
Volume
10
Pages
1–5
Identifiers
DOI: 10.2147/BLCTT.S262592
PMID: 32943973
PMCID: PMC7473982
Source
PubMed Central
Keywords
Disciplines
  • Original Research
License
Green

Abstract

Introduction Recent randomized trials have demonstrated the efficacy of ibrutinib-based therapy in the treatment of patients with CLL. In Alliance A041202, a higher than expected number of unexplained deaths were reported with front-line ibrutinib in a patient population aged at least 65 years compared to ECOG 1912, which included patients up to 70 years of age. Methods Therefore, we conducted a retrospective analysis to investigate whether ibrutinib was associated with a greater mortality in older patients outside of a clinical trial setting. This multicenter analysis was performed by investigators at 20 academic and community practices. Results Amongst the 391 patients included, there was no correlation between age and response rate, PFS, or OS. However, there was a trend to higher rate of deaths in patients >65-years-old (8.7% vs 3.8%, p=0.097), with an increased number of early deaths (13 vs 4, p=0.3). Conclusion These data suggest greater intolerance, and possibly mortality, with ibrutinib in an older population. Patients should be educated regarding the potential complications related to ibrutinib and symptoms of concern to report.

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