Best Practices to Overcoming Challenges in Initiating Venetoclax for Patients with Chronic Lymphocytic Leukemia: Results from a United States Community-Based Healthcare Practitioner Survey

• Published in: Blood 2024-11, Vol.144, p.2268-2268
• Main Authors: Jacobs, Ryan, Fletcher, Luke, Rettew, Andrew, Li, Sophia S, Eakle, Katherine, Shahkarami, Mina, Wang, Rongrong, To, Tu My, Mathias, Susan D, Manigault, Isabella, Burke, John M.
• Format: Article
• Language: English
• ISSN: 0006-4971
• DOI: 10.1182/blood-2024-198466

Background: Initial treatment (tx) for patients (pts) with chronic lymphocytic leukemia (CLL) currently consists of either Bruton's tyrosine kinase inhibitor (BTKi)-based or venetoclax (Ven)-based combination regimens. While both are effective, differences in administration and potential adverse effects exist. BTKi-based regimens are logistically easy with simple administration; but pts must be on continuous tx until disease progression (PD) or toxicity. Over time, cancer cells gradually develop acquired resistance, leading to reduced effectiveness, PD, and the potential for more adverse events. Ven-based combination regimens are often given as a fixed-duration tx (FDT) that selectively binds to B-cell lymphoma 2, achieving deep remission and durable responses, potentially allowing pts to benefit from years off tx; however, some healthcare practitioners (HCPs) still perceive the initiation process to be a barrier to Ven use. How these factors affect tx decisions between these regimens is poorly understood. This study aimed to understand the perspectives of community-based practitioners regarding best practices and challenges when initiating Ven-based regimens as initial tx for CLL. Methods: In June 2024, an online cross-sectional survey was completed by hematologists, oncologists, and advanced practice providers in the US. The Aptitude Health Axess Network, comprising HCPs who collaborate as advisors to life science companies to share their knowledge of the oncology market, clinical science, and patient care, was used to recruit providers. HCPs were eligible if they practiced in the community setting, had ≥5 years of practice (post-residency), treated ≥10 pts with CLL per year, currently treat ≥1 patient with CLL with Ven, and either initiated Ven or remained the primary HCP for CLL if the patient was referred out for Ven ramp-up. HCPs were paid a market rate for their time to complete the survey. HCPs were asked about best practices and challenges when starting Ven as initial tx for CLL. Descriptive statistics were used to analyze HCP practice characteristics, best practices, challenges, and tx decision making. Results: A total of 1160 HCPs were approached. Among the 103 community HCP respondents, most of whom were physicians (n=94; 91%), almost all (n=97; 94%) reported initiating Ven in their practice. Most HCPs (n=100; 97%) reported having best practices or educational resources that support the successful initiation of Ven at their site. The most commo