Population-level impact of ibrutinib for chronic lymphocytic leukemia in British Columbia, Canada

• Published in: Leukemia & lymphoma 2023-05, Vol.64 (6), p.1129-1138
• Main Authors: Khelifi, Rania S., Huang, Steven J., Savage, Kerry J., Villa, Diego, Scott, David W., Ramadan, Khaled, Connors, Joseph M., Sehn, Laurie H., Toze, Cynthia L., Gerrie, Alina S.
• Format: Article
• Language: English
• Subjects: BTK inhibitor; Chronic lymphocytic leukemia; ibrutinib; population-based; real-world
• ISSN: 1042-8194; 1029-2403
• DOI: 10.1080/10428194.2023.2199340

Ibrutinib has dramatically changed the treatment landscape for chronic lymphocytic leukemia (CLL) since its availability in British Columbia (BC), Canada in 2014. We analyzed patterns of use and real-world survival outcomes in 370 patients who received ibrutinib for first-line (1 L, n = 35) and relapsed/refractory (R/R, n = 335) CLL between 2014-2018 in BC. Dose reductions and interruptions were frequent in 32% and 27%, respectively. With a median follow-up of 27.6 months, 35% of patients discontinued ibrutinib, primarily for adverse events (AEs) rather than progressive disease. Over the course of treatment, 87% of patients experienced at least one adverse event. The 2-year overall survival (OS) and event-free survival (EFS) were excellent at 83.9% and 76.1%, respectively, with medians not reached. However, patients who discontinued ibrutinib had a median OS of 32.5 months and median EFS of only 3.8 months from time of discontinuation, highlighting the need to minimize toxicity in the real-world.