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Outcomes in CLL Patients Treated with Sequential KIs
Blood; ePub 2016 Sep 7; Mato, Nabhan, Barr, et al
Toxicity was the most common reason for kinase inhibitor (KI) discontinuation in people with chronic lymphocytic leukemia (CLL) in a multicenter, retrospective analysis involving 178 individuals. Additionally, those who discontinued usually responded to an alternate KI.
Participants were taking either ibrutinib or idelalisib, and discontinued. Investigators looked at responses, toxicity, post-KI therapies, and overall survival. Among the results:
• Overall response rate to initial KI was 62%, and complete response rate was 14%.
• Half discontinued due to toxicity; other reasons included CLL progression (29%), and Richter's transformation (RT) (8%).
• Median progression-free survival from KI initiation was ~11 months; median overall survival was 29 months.
• RT predicted significantly inferior overall survival.
• 114 patients took another KI; half responded to treatment, and median progression-free survival was nearly a year for them.
• Median progression-free survival for those intolerant to KIs who nonetheless took an alternative was not reached.
Mato A, Nabhan C, Barr P, et al. Outcomes of CLL patients treated with sequential kinase inhibitor therapy: A real world experience. [Published online ahead of print September 7, 2016]. Blood. doi:10.1182/blood-2016-05-716977.