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 and P. GHIA. 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. Cancer Medicine. Houston: John Wiley & Sons Ltd., 2020, vol. 9, No 22, p. 8468-8479. ISSN 2045-7634. Available from: https://dx.doi.org/10.1002/cam4.3470.
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Basic information
Original name 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
Authors CUNEO, A. (380 Italy, guarantor), A. R. MATO (840 United States of America), G. M. RIGOLIN (380 Italy), A. PICIOCCHI (380 Italy), M. GENTILE (380 Italy), L. LAURENTI (380 Italy), J. N. ALLAN (840 United States of America), J. M. PAGEL (840 United States of America), DM BRANDER (840 United States of America), B. T. HILL (840 United States of America), A. WINTER (840 United States of America), N. LAMANNA (840 United States of America), C. S. TAM (36 Australia), R. JACOBS (840 United States of America), F. LANSIGAN (840 United States of America), P. M. BARR (840 United States of America), M. SHADMAN (840 United States of America), A. P. SKARBNIK (840 United States of America), J. F. J. PU (840 United States of America), A. R. SEHGAL (840 United States of America), S. J. SCHUSTER (840 United States of America), N. I. N. SHAH (840 United States of America), C. S. UJJANI (840 United States of America), L. ROEKER (840 United States of America), E. M. ORLANDI (380 Italy), A. BILLIO (380 Italy), L. TRENTIN (380 Italy), M. SPACEK (203 Czech Republic), M. MARCHETTI (380 Italy), A. TEDESCHI (380 Italy), F. ILARIUCCI (380 Italy), G. GAIDANO (380 Italy), Michael DOUBEK (203 Czech Republic, belonging to the institution), L. FARINA (380 Italy), S. MOLICA (380 Italy), F. DI RAIMONDO (380 Italy), M. COSCIA (380 Italy), F. R. MAURO (380 Italy), J. DE LA SERNA (724 Spain), A. M. PEREZ (724 Spain), I. FERRARINI (380 Italy), G. CIMINO, M. CAVALLARI (380 Italy), R. CUCCI (380 Italy), M. VIGNETTI (380 Italy), R. FOA (380 Italy) and P. GHIA (380 Italy).
Edition Cancer Medicine, Houston, John Wiley & Sons Ltd. 2020, 2045-7634.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30204 Oncology
Country of publisher United States of America
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 4.452
RIV identification code RIV/00216224:14110/20:00116594
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1002/cam4.3470
UT WoS 000572155000001
Keywords in English bendamustine; chronic lymphocytic leukemia; ibrutinib; real-world analysis; unfit patients
Tags 14110212, rivok
Tags International impact, Reviewed
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 24/11/2020 12:13.
Abstract
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.
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