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The Efficacy and Safety of Venetoclax Therapy in Elderly Patients with Relapsed, Refractory Chronic Lymphocytic Leukaemia

Abstract

Elderly chronic lymphocytic leukaemia (CLL) patients treated outside of trials have notably greater toxicity with the Bruton's tyrosine kinase inhibitor ibrutinib compared to younger patients. It is not known whether the same holds true for the B-cell lymphoma 2 inhibitor venetoclax. We provide a comprehensive analysis of key safety measures and efficacy in 342 patients comparing age categories ≥75 and <75 years treated in the relapsed, refractory non-trial setting. We demonstrate that venetoclax has equivalent efficacy and safety in relapsed/refractory CLL patients who are elderly, the majority of whom are previous ibrutinib-exposed and therefore may otherwise have few clear therapeutic options.

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References
1.
Woyach J, Ruppert A, Heerema N, Zhao W, Booth A, Ding W . Ibrutinib Regimens versus Chemoimmunotherapy in Older Patients with Untreated CLL. N Engl J Med. 2018; 379(26):2517-2528. PMC: 6325637. DOI: 10.1056/NEJMoa1812836. View

2.
Davids M, Hallek M, Wierda W, Roberts A, Stilgenbauer S, Jones J . Comprehensive Safety Analysis of Venetoclax Monotherapy for Patients with Relapsed/Refractory Chronic Lymphocytic Leukemia. Clin Cancer Res. 2018; 24(18):4371-4379. DOI: 10.1158/1078-0432.CCR-17-3761. View

3.
Eyre T, Kirkwood A, Gohill S, Follows G, Walewska R, Walter H . Efficacy of venetoclax monotherapy in patients with relapsed chronic lymphocytic leukaemia in the post-BCR inhibitor setting: a UK wide analysis. Br J Haematol. 2019; 185(4):656-669. DOI: 10.1111/bjh.15802. View

4.
Schemper M, Smith T . A note on quantifying follow-up in studies of failure time. Control Clin Trials. 1996; 17(4):343-6. DOI: 10.1016/0197-2456(96)00075-x. View

5.
Moreno C, Greil R, Demirkan F, Tedeschi A, Anz B, Larratt L . Ibrutinib plus obinutuzumab versus chlorambucil plus obinutuzumab in first-line treatment of chronic lymphocytic leukaemia (iLLUMINATE): a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol. 2018; 20(1):43-56. DOI: 10.1016/S1470-2045(18)30788-5. View