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From a 2DE-Gel Spot to Protein Function: Lesson Learned From HS1 in Chronic Lymphocytic Leukemia
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Comorbidities predict inferior outcomes in chronic lymphocytic leukemia treated with ibrutinib

Max J Gordon1, Michael Churnetski2, Hamood Alqahtani3

  • 1Oregon Health and Science University, Portland, Oregon.

Cancer
|May 26, 2018
PubMed

Insights

Comorbidities negatively impact outcomes for chronic lymphocytic leukemia (CLL) patients treated with ibrutinib. Higher comorbidity scores predict worse event-free survival and overall survival in CLL patients receiving targeted therapy.

Area of Science:

  • Hematology
  • Oncology
  • Clinical Research

Background:

  • Most chronic lymphocytic leukemia (CLL) patients have multiple comorbidities.
  • Comorbidities negatively impact outcomes in chemoimmunotherapy-treated CLL patients.
  • The effect of comorbidities on outcomes with targeted therapies in CLL is not well understood.

Purpose of the Study:

  • To evaluate the significance of comorbidities in CLL patients treated with ibrutinib.
  • To assess the impact of comorbidity burden on event-free survival (EFS) and overall survival (OS).

Main Methods:

  • Multicenter, retrospective analysis of 145 CLL patients treated with ibrutinib.
  • Comorbidities assessed using the Cumulative Illness Rating Scale (CIRS).
  • Analysis included patients in frontline and relapsed/refractory settings.

Main Results:

  • High comorbidity burden (CIRS score ≥ 7) associated with inferior median EFS (24 vs 37 months) and 2-year OS (79% vs 100%).
  • Increased CIRS score correlated with worse EFS and OS in adjusted Cox models.
  • Comorbidities linked to higher risk of ibrutinib dose reduction and treatment discontinuation.

Conclusions:

  • Comorbidities indicate a poor prognosis for CLL patients receiving ibrutinib.
  • CIRS score is a predictive factor for outcomes in both frontline and relapsed CLL.
  • Further prospective studies are needed to optimize treatment strategies for CLL patients with comorbidities.
Abstract

Keywords:
Cumulative Illness Rating Scale (CIRS)chronic lymphocytic leukemia (CLL)geriatric oncologyibrutinibtargeted agents

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