Outcomes of U.S. military veterans with chronic lymphocytic leukemia (CLL) treated with different first-line treatments from 1998 to 2020.

In this decades-long retrospective study, 6,332 U.S. military veterans found that first-line treatment of CLL with targeted therapies resulted in longer overall survival (OS) compared with chemotherapy or monoclonal antibodies. The VA Centra Cancer Registry analyzed treatment patterns from 1998 to 2005, and 2005 to 2020. Use of targeted agents as frontline therapy in CLL increased from 0% in 2005 to 80% in 2020; the most commonly used targeted agent was ibrutinib (93%). Researchers used a multivariate Cox regression analysis and found that use of targeted therapies in the frontline setting significantly improved OS compared to frontline chemotherapy (HR, 0.637; 95% CI: 0.543 - 0.747, p < .0001), and any exposure to targeted treatments was associated with improved survival (HR, 0.424; 95% CI: 0.384 - 0.468, p < .0001)