Real‐world outcomes upon second‐line treatment in patients with chronic lymphocytic leukaemia

Abstract

SummaryFor chronic lymphocytic leukaemia (CLL), targeted drugs have become the standard of care, in particular for second‐line treatment. In this study, overall survival (OS), treatment‐free survival (TFS) and adverse events (AE) were registered retrospectively in a Danish population‐based cohort upon second‐line treatment for CLL. Data were collected from medical records and the Danish National CLL register. For 286 patients receiving second‐line treatment, three‐year TFS was higher upon targeted treatment (ibrutinib/venetoclax/idelalisib) [63%, 95% confidence interval (CI) 50%–76%] compared with fludarabine, cyclophosphamide and rituximab or bendamustine and rituximab (FCR/BR) (37%, CI: 26%–48%) and chlorambucil+/−CD20‐antibody (CD20Clb/Clb) (22%, CI: 10%–33%). Upon targeted treatment, three‐year OS estimates were higher for targeted treatment (79%, CI: 68%–91%) compared with FCR/BR (70%, CI: 60%–81%) or CD20Clb/Clb (60%, CI: 47%–74%). The most common AEs were infections and haematological AEs; 92% of patients treated with targeted drugs had AEs, 53% of which were severe. Upon FCR/BR and CD20Clb/Clb, AEs were present for 75% and 53% respectively, of which 63% and 31% were severe. These real‐world data demonstrate higher TFS and a tendency towards higher OS following targeted second‐line treatment for CLL compared to chemoimmunotherapy, also for patients who may be frailer and more comorbid.