Examining Treatment Patterns and Real-World Outcomes in Chronic Lymphocytic Leukemia Using Administrative Data in...

Area of Science:

• Hematology
• Oncology
• Real-world evidence

Background:

• Limited real-world data exists on chronic lymphocytic leukemia (CLL) treatment patterns and outcomes in Canada.
• Ontario administrative data provides a valuable resource for studying population-level health information.

Purpose of the Study:

• To report on the treatment patterns and outcomes of chronic lymphocytic leukemia (CLL) in Ontario, Canada.
• To analyze the impact of evolving treatment landscapes on patient survival.

Main Methods:

• Retrospective cohort study of 2887 CLL patients diagnosed and treated between January 1, 2010, and December 31, 2017.
• Utilized data from the Ontario Cancer Registry (OCR) and the Institute of Clinical Evaluative Sciences (ICES).
• Compared survival outcomes based on frontline treatments (FCR, chlorambucil) and treatment era (pre- and post-2015 funding of novel agents).

Main Results:

• Fludarabine, cyclophosphamide, and rituximab (FCR) was a common first-line treatment, but its use decreased after 2015 with the funding of ibrutinib and obinutuzumab combinations.
• Survival rates at one and four years improved significantly for patients treated with frontline FCR post-2015 compared to pre-2015.
• Survival rates for patients on frontline chlorambucil showed modest improvements post-2015.

Conclusions:

• The shift towards newer and novel agents in first-line or relapsed/refractory settings has demonstrably improved survival outcomes for CLL patients.
• Real-world data from Ontario confirms the positive impact of treatment advancements on chronic lymphocytic leukemia patient survival.