Yale School of Medicine, New Haven, CT, USA.
Analysis Group, Inc, Boston, MA, USA.
Leuk Lymphoma. 2024 Jul;65(7):932-942. doi: 10.1080/10428194.2024.2331631. Epub 2024 May 2.
With increasing focus on novel targeted therapies for chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), this longitudinal claims-based study evaluated real-world CLL/SLL treatment sequences, particularly sequential targeted therapy. Among patients with first-line (1 L) treatment in 2014-2017 ( = 2,612; median follow-up = 3 years), the most common 1 L treatment was chemoimmunotherapy (CIT; 44.6%), followed by CD20 (25.2%) and Bruton's tyrosine kinase inhibitors (BTKi; 21.7%). Among those with 1 L in 2018-2021 ( = 4,534; median follow-up = 1 year), these were BTKi (45.5%), CD20 (20.4%), CIT (17.5%), and B-cell lymphoma 2 inhibitor (8.3%). In 2014-2017, the proportion of patients receiving sequential targeted therapy in the first 2 LOTs was 11.2% (80.2% was BTKi→BTKi); in 2018-2021, this proportion was 34.3% (66.4% was BTKi→BTKi). Over time, there was a substantial increase in targeted therapy use in 1 L and sequential targeted therapy, particularly with BTKi→BTKi. Future studies should assess clinical outcomes to determine optimal sequences for CLL/SLL and reasons for restarting BTKi.
随着对慢性淋巴细胞白血病/小淋巴细胞淋巴瘤（CLL/SLL）新型靶向治疗的关注度不断提高，这项基于纵向索赔的研究评估了真实世界的 CLL/SLL 治疗方案，特别是序贯靶向治疗。在 2014-2017 年接受一线（1L）治疗的患者中（n=2612；中位随访时间=3 年），最常见的 1L 治疗是化疗免疫治疗（CIT；44.6%），其次是 CD20（25.2%）和布鲁顿酪氨酸激酶抑制剂（BTKi；21.7%）。在 2018-2021 年接受 1L 治疗的患者中（n=4534；中位随访时间=1 年），这些患者中 BTKi（45.5%）、CD20（20.4%）、CIT（17.5%）和 B 细胞淋巴瘤 2 抑制剂（8.3%）。在 2014-2017 年，前 2 个 LOT 中接受序贯靶向治疗的患者比例为 11.2%（80.2%是 BTKi→BTKi）；在 2018-2021 年，这一比例为 34.3%（66.4%是 BTKi→BTKi）。随着时间的推移，1L 和序贯靶向治疗的靶向治疗使用率大幅增加，尤其是 BTKi→BTKi。未来的研究应评估临床结果，以确定 CLL/SLL 的最佳治疗方案，并确定重新启动 BTKi 的原因。
