Research Article: Disease characteristics, treatment, and outcomes in Chinese chronic lymphocytic leukemia patients following BTK inhibitor discontinuation: a multicenter real-world study
Abstract:
Utilization of novel Bruton tyrosine kinase inhibitors (BTKi) has become common for treating CLL/SLL patients, yet limited evidence exists on the clinical characteristics and outcomes following BTKi therapy discontinuation in China. This multicenter retrospective study analyzed 37 CLL/SLL patients in China who discontinued BTKi therapy. The mean age at discontinuation was 62.67 years, with the majority being male (67.57%). Most patients (62.16%) were relapsed/refractory (R/R) CLL/SLL patients prior to BTKi treatment, and 37.84% were treatment-naïve patients. Treatment-naïve patients were significantly younger than R/R patients (56.93 vs. 66.16 years, p = 0.005). Discontinuation reasons included resistance (48.65%), intolerance (32.43%), and other factors (18.92%). The most frequently used regimen among the post-BTKi first subsequent therapies was the anti-CD20 antibody combination therapy (52.90%). The overall disease control rate during BTKi treatment was 78.13%. The median progression-free survival (PFS) for BTKi therapy was 19.09 months, 19.09 months for treatment-naïve patients, and 14.39 months for R/R patients. The minimum median PFS was observed in patients with resistance (7.86 months). After BTKi discontinuation, median PFS was shorter: 8.87 months for first subsequent therapy and 5.32 months for second subsequent therapy. No significant difference was observed in overall survival. These findings illustrate the impact of prior treatment and discontinuation reasons on subsequent outcomes.
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