MedPath

Patient-Reported QOL Outcomes of Initial CLL Treatments Highlighted at ASH 2024

New research presented at the 2024 American Society of Hematology Annual Meeting reveals significant findings on patient-reported outcomes for those undergoing first-line treatment for chronic lymphocytic leukemia, including financial toxicity, health-related quality of life, and medication adherence.

New research presented in two abstracts at the 2024 American Society of Hematology (ASH) Annual Meeting & Exposition has shed light on patient-reported outcomes (PROs) in individuals receiving first-line treatment for chronic lymphocytic leukemia (CLL).
Financial Toxicity and Nonadherence A study involving 47 patients undergoing first-line oral oncolytic therapy (OOT) found that 51% received BTK inhibitors, mostly acalabrutinib and zanubrutinib (43%), while 53% received concurrent obinutuzumab. This research highlighted the risk of early and progressive financial toxicity and suboptimal adherence among these patients. The study suggested that assessing financial toxicity and nonadherence soon after OOT initiation is crucial, as these issues are significantly associated with inferior health-related quality of life (HRQOL).
Despite most patients having insurance coverage, significant financial toxicity was observed in 22%, 33%, and 28% of patients at baseline, 3 months, and 6 months, respectively. Financial toxicity was strongly associated with inferior HRQOL at all timepoints and with inferior medication adherence at baseline. Suboptimal OOT adherence was reported by 34%, 39%, and 48% of patients at baseline, 3 months, and 6 months, respectively.
Timing of QOL Improvements Varies Another study involving 863 participants from the phase 3 GAIA/CLL13 trial focused on patients taking venetoclax-based combinations for first-line CLL treatment. It found that improvements in QOL measures and key functioning scales occurred shortly after treatment initiation in patients treated with doublets, venetoclax-obinutuzumab (GV) or venetoclax-rituximab (RV). However, similar improvements in patients taking the triplet venetoclax-obinutuzumab-ibrutinib (GIV) were reported later after the end of treatment. Improvements were smaller and seen later for patients receiving chemoimmunotherapy (CIT).
The difference in the timing of QOL improvements between patients taking the triplet combination versus the doublets seems to be influenced by a higher symptom burden during GIV treatment. This factor should be considered when comparing efficacy outcomes of different venetoclax combinations in CLL.
Changes in functioning scales, global health status (GHS)/QOL, and symptoms were assessed using the EORTC QLQ-C30 and QLQ-CLL16 questionnaires. In the RV and GV arms, GHS improved after initiation of treatment, and mean changes from baseline above the minimal important difference (MID) were maintained throughout the study. In the GIV arm, no mean increase above the MID was observed during the first 12 months of treatment, but it was seen at month 15 when most patients had finished treatment. In the CIT arm, the first mean improvement above MID was reported at month 24.
Subscribe Icon

Stay Updated with Our Daily Newsletter

Get the latest pharmaceutical insights, research highlights, and industry updates delivered to your inbox every day.

Related Topics

Pooled Analysis Shows Improved OS Outcomes with Ibrutinib Plus Venetoclax in CLL Patients

A pooled analysis of the GLOW trial and CAPTIVATE-FD study reveals that first-line, fixed-duration treatment with ibrutinib plus venetoclax significantly improves overall survival (OS) outcomes in treatment-naive chronic lymphocytic leukemia (CLL) patients, with OS estimates comparable to an age-matched general European population.

Axi-Cel Therapy Shows Reduced Toxicities in Large B-Cell Lymphoma Treatment

Axicabtagene ciloleucel (axi-cel) therapy demonstrates a significant decrease in the severity and duration of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS).
The reduced severity of CRS and ICANS leads to improved patient outcomes, including a decreased need for intensive care and shorter hospital stays, enhancing the risk-benefit profile of axi-cel.

Soylent Meal Replacement Improves Quality of Life in Head and Neck Cancer Patients Undergoing Chemoradiation

A phase II study evaluated Soylent, a liquid meal replacement, in head and neck cancer patients undergoing chemoradiation to prevent malnutrition and maximize quality of life.
The study demonstrated high patient adherence to Soylent, with 94% of patients successfully transitioning to exclusive meal replacement after experiencing a 5% body weight loss.

Estimand Framework Enhances Analysis of Patient-Reported Outcomes in Lung Cancer Trials

A recent study emphasizes the importance of the estimand framework in analyzing patient-reported outcomes (PROs) within single-arm trials, particularly in oncology.
The research illustrates various estimands for assessing global Quality of Life (QoL) in patients with ALK-positive non-small cell lung cancer.

Delayed Treatment May Improve Outcomes for Older DLBCL Patients, Study Suggests

A recent study indicates that older adults with Diffuse Large B-cell Lymphoma (DLBCL) who delay treatment initiation may experience better outcomes.
Patients starting treatment within one to two weeks of diagnosis showed shorter times to next-line therapy and reduced overall survival.

Fixed-Duration Venetoclax Regimen Reduces Long-Term Costs in CLL Treatment

A real-world study shows that fixed-duration venetoclax-based treatment for chronic lymphocytic leukemia (CLL) results in lower long-term healthcare costs compared to continuous Bruton tyrosine kinase inhibitor (BTKi) therapy.
The venetoclax regimen was associated with an $8000 cost decrease six months after the fixed-duration period, primarily due to the absence of prescription drug costs.

Chronic Hand Eczema Significantly Impairs Patients' Quality of Life, Study Shows

Patients with moderate to severe chronic hand eczema (CHE) experience significant negative impacts on daily activities, emotional well-being, and social functioning.
Exit interviews from the DELTA 1 clinical trial reveal that CHE affects patients' ability to perform tasks, leading to frustration, embarrassment, and reduced self-esteem.

Fixed-Duration Venetoclax Regimens Offer CLL Patients a Balanced Approach

Fixed-duration treatments in CLL offer a defined treatment period, contrasting with continuous therapies that require ongoing administration until disease progression or unacceptable toxicity.
Venetoclax-based regimens, such as venetoclax plus obinutuzumab for 12 cycles in the frontline setting, provide a time-limited treatment option.

Lisocabtagene Maraleucel Shows Consistent Benefit in High-Risk CLL Subgroups

Lisocabtagene maraleucel (liso-cel) demonstrates consistent objective response rates (ORR) and complete response (CR) in relapsed/refractory chronic lymphocytic leukemia (CLL) patients, irrespective of high-risk features like unmutated IGHV or TP53 mutations.
Lower tumor burden correlates with improved response to liso-cel, suggesting that debulking strategies prior to treatment may enhance outcomes in CLL/SLL patients.

Quality of Life Measures Gain Traction in Cancer Clinical Trials

A nationwide clinical trial is assessing the quality of life (QoL) in young Hodgkin lymphoma patients, marking a shift towards accessible and interpretable patient-reported outcomes.
The addition of brentuximab vedotin to chemotherapy showed clinical superiority and fewer negative effects on QoL compared to standard treatment, highlighting the importance of reducing late-term toxicities.

Reference News

[1]
Patient-Reported QOL Outcomes of Initial CLL Treatments: ASH 2024
ajmc.com · Jan 8, 2025

Research at ASH 2024 highlighted financial toxicity and nonadherence in CLL patients on first-line oral oncolytic therap...

© Copyright 2025. All Rights Reserved by MedPath
HomeTerms & ConditionsPrivacy Policy