2020
Efficacy of bendamustine and rituximab in unfit patients with previously untreated chronic lymphocytic leukemia. Indirect comparison with ibrutinib in a real-world setting. A GIMEMA-ERIC and US study
CUNEO, A.; A. R. MATO; G. M. RIGOLIN; A. PICIOCCHI; M. GENTILE et al.Základní údaje
Originální název
Efficacy of bendamustine and rituximab in unfit patients with previously untreated chronic lymphocytic leukemia. Indirect comparison with ibrutinib in a real-world setting. A GIMEMA-ERIC and US study
Autoři
CUNEO, A.; A. R. MATO; G. M. RIGOLIN; A. PICIOCCHI; M. GENTILE; L. LAURENTI; J. N. ALLAN; J. M. PAGEL; DM BRANDER; B. T. HILL; A. WINTER; N. LAMANNA; C. S. TAM; R. JACOBS; F. LANSIGAN; P. M. BARR; M. SHADMAN; A. P. SKARBNIK; J. F. J. PU; A. R. SEHGAL; S. J. SCHUSTER; N. I. N. SHAH; C. S. UJJANI; L. ROEKER; E. M. ORLANDI; A. BILLIO; L. TRENTIN; M. SPACEK; M. MARCHETTI; A. TEDESCHI; F. ILARIUCCI; G. GAIDANO; Michael DOUBEK; L. FARINA; S. MOLICA; F. DI RAIMONDO; M. COSCIA; F. R. MAURO; J. DE LA SERNA; A. M. PEREZ; I. FERRARINI; G. CIMINO; M. CAVALLARI; R. CUCCI; M. VIGNETTI; R. FOA a P. GHIA
Vydání
Cancer Medicine, Houston, John Wiley & Sons Ltd. 2020, 2045-7634
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30204 Oncology
Stát vydavatele
Spojené státy
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 4.452
Označené pro přenos do RIV
Ano
Kód RIV
RIV/00216224:14110/20:00116594
Organizační jednotka
Lékařská fakulta
UT WoS
EID Scopus
Klíčová slova anglicky
bendamustine; chronic lymphocytic leukemia; ibrutinib; real-world analysis; unfit patients
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 24. 11. 2020 12:13, Mgr. Tereza Miškechová
Anotace
V originále
Limited information is available on the efficacy of front-line bendamustine and rituximab (BR) in chronic lymphocytic leukemia (CLL) with reduced renal function or coexisting conditions. We therefore analyzed a cohort of real-world patients and performed a matched adjusted indirect comparison with a cohort of patients treated with ibrutinib. One hundred and fifty-seven patients with creatinine clearance (CrCl) 6 were treated with BR. The median age was 72 years; 69% of patients had >= 2 comorbidities and the median CrCl was 59.8 mL/min. 17.6% of patients carried TP53 disruption. The median progression-free survival (PFS) was 45 months; TP53 disruption was associated with a shorter PFS (P = 0.05). The overall survival (OS) at 12, 24, and 36 months was 96.2%, 90.1%, and 79.5%, respectively. TP53 disruption was associated with an increased risk of death (P = 0.01). Data on 162 patients >= 65 years treated with ibrutinib were analyzed and compared with 165 patients >= 65 years treated with BR. Factors predicting for a longer PFS at multivariable analysis in the total patient population treated with BR and ibrutinib were age (HR 1.06, 95% CI 1.02-1.10,P < 0.01) and treatment with ibrutinib (HR 0.55, 95% CI 0.33-0.93,P = 0.03). In a post hoc analysis of patients in advanced stage, a significant PFS advantage was observed in patient who had received ibrutinib (P = 0.03), who showed a trend for OS advantage (P = 0.08). We arrived at the following conclusions: (a) BR is a relatively effective first-line regimen in a real-world population of unfit patients without TP53 disruption, (b) ibrutinib provided longer disease control than BR in patients with advanced disease stage.