Impact of targeted agents on survival of chronic lymphocytic leukemia patients age >65 relative to age- and sex-matched population

Authors presented data from a pooled analysis of several phase 3 clinical trials, with a specific focus on comparing overall survival amongst patients with CLL who were aged 65 years and older and treated with targeted agents in the frontline setting, compared to age- and sex-matched general population. Patients were sorted into four treatment categories: 1) BTKi monotherapy, 2) BTKi + anti-CD20, 3) fixed-duration venetoclax-based combination therapy, and 4) traditional chemotherapy or chemoimmunotherapy. The authors found that the restricted mean survival time (RMST) was highest for patients treated with BTK inhibitors in the frontline setting, either alone or in combination with an anti-CD20 monoclonal antibody, and patients treated with chemotherapy or chemoimmunotherapy in the frontline setting had the lowest RMST. Comparison of 5-year overall survival (OS) rates demonstrated no significant difference between patients with CLL aged 65 or older treated with either a BTK inhibitor or BTK inhibitor plus anti-CD20 monoclonal antibody in the frontline setting when compared to the US age and sex-matched general population. Of note, there was an improvement in 5-year OS observed in patients with CLL aged 65 or older treated with acalabrutinib compared to ibrutinib in the frontline setting.