Treatment discontinuation patterns for patients with chronic lymphocytic leukemia in real-world settings: results from a multi-center international study.

In this study, authors assessed real-word treatment discontinuation rates across an international cohort of patients with CLL in the firstline (1L) and secondline (2L) setting. More specifically, the study compares discontinuation rates for historical chemoimmunotherapy regimens (either FCR or BR), venetoclax-based regimens, and regimens containing BTK inhibitors. In the frontline setting, highest rates of premature discontinuation of therapy were seen with BR (34.5%), followed by BTKi-based therapy (28.1%) and FCR (23.7%), with the lowest rates of premature discontinuation of therapy seen with venetoclax-based regimens (16.3%). In the frontline setting, adverse events were the most common reason for premature treatment discontinuation with chemoimmunotherapy (FCR or BR) and BTKi-based regimens, whereas disease progression was the reason for premature discontinuation of therapy in 7% of patients on venetoclax-based therapy. Premature discontinuation rates were universally higher in the 2L setting, most commonly due to adverse events. Several factors likely play into these results, including factors such as patient age and other comorbidities driving clinician choice of therapy. Overall, these results highlight opportunities for improved management of adverse events to optimize duration of therapy, as well as the ongoing need to address tolerability of CLL therapy in the real-world setting.