CLL-449 Patterns of Treatment and Prognostic Testing Among Black Patients With Chronic Lymphocytic Leukemia (CLL): Results From informCLL, a Prospective, Observational Registry.

OBJECTIVE: To evaluate real-world treatment patterns and prognostic biomarker testing in Black patients with CLL enrolled in informCLL. PATIENTS AND METHODS: informCLL, a US-based, prospective, observation registry, enrolled patients who initiated FDA-approved treatment for CLL/SLL (October 2015 - June 2019). Baseline characteristics, FISH testing rates, and patterns of treatment were summarized by lines of therapy (LOT). RESULTS: Of 1462 enrolled patients, 106 (7%) were Black. Black patients were predominantly enrolled in the South (69%) and from community-based practices (87%). Compared with the overall registry population, Black patients were younger (median age 66 years vs 71 years), had higher proportions with ECOG status ≥1 (65% vs 53%) and Rai stage III-IV (64% vs 51%), and similar time from diagnosis to treatment on registry (median 40 months vs 41 months) but shorter time from diagnosis to first-line treatment (median 7 months vs 19 months). FISH testing rates were similar (25% vs 28%). In a multivariate analysis (performed in overall registry population), baseline factors associated with FISH testing were shorter time from diagnosis to treatment, better ECOG status, earlier LOT (first-line), community practice setting, and a prior malignancy (p<0.05 for all); race was not a predictive factor. As observed in the overall population, ibrutinib was the most frequent treatment among Black patients in first-line (50%) and R/R (67%) settings, followed by chemoimmunotherapy (first-line, 43%; R/R, 15%). In the first-line cohort, ibrutinib use generally increased over time (2016, 31%; 2017, 57%; 2018, 63%; 2019, 55%) while chemoimmunotherapy use persisted (56%, 36%, 38%, and 36%, respectively). In R/R patients, ibrutinib use decreased over time while chemoimmunotherapy remained consistent. CONCLUSIONS: In informCLL, Black patients with CLL tended to be younger, with worse ECOG status, more advanced disease, and shorter time to first-line therapy than the overall registry population. Black patients may need close monitoring of disease status as they will tend to require initial CLL therapy more rapidly than other patients. Although ibrutinib was the most common treatment in Black patients, chemoimmunotherapy use remained persistent. Prognostic testing rates were suboptimal in Black patients, similar to the overall population. ©2022 American Society of Clinical Oncology, Inc. Reused with permission. This abstract was accepted and previously presented at the 2022 ASCO Annual Meeting. All rights reserved.

Duke Scholars

Author Danielle Marie Brander Medicine, Hematologic Malignancies and Cellular Therapy