Real-World Treatment Patterns, Clinical Outcomes, and Healthcare Resource Utilization of Patients with Chronic Lymphocytic Leukemia Treated with Fixed Duration Therapy in a First-Line Setting in Alberta, Canada
Author(s)
Sydney A. George, MSc1, Sandra Thibault, PhD1, Mariet Stephen, MSc2, Carolyn Owen, MD3, Mackenzie A. Hamilton, MPH1, Vivian Vuong, MBDC1, Winson Cheung, MD, MPH2;
1AstraZeneca Canada, Mississauga, ON, Canada, 2Oncology Outcomes, Calgary, AB, Canada, 3University of Calgary, Calgary, AB, Canada
1AstraZeneca Canada, Mississauga, ON, Canada, 2Oncology Outcomes, Calgary, AB, Canada, 3University of Calgary, Calgary, AB, Canada
OBJECTIVES: Chronic lymphocytic leukemia (CLL) is the most common adult leukemia in Canada. Several standard-of-care options are available, including treat-to-progression regimens and fixed duration (FD) therapies such as chemotherapies and, recently, targeted FD treatments. A treatment shift towards targeted FD therapies provides patients with a drug holiday from continuous treatment while reducing cumulative adverse events and healthcare resource use (HCRU). However, there is limited Canadian data on current treatment patterns, clinical outcomes, and HCRU of CLL patients treated with FD therapies, especially in context of emerging targeted treatments.
METHODS: An observational study was conducted with health administrative data from Alberta, Canada. The study population includes adult patients diagnosed with CLL between January 1, 2010, and December 31, 2022, and who initiated FD therapy in a first-line (1L) setting between January 1, 2010 and December 31, 2023.
RESULTS: 589 CLL patients were identified; 69.9 % were male, and median age (at diagnosis) was 65 years. In recent years (2021-2023), a majority of patients received Venetoclax + Obinutuzumab (V+O) (N=88, 58.7%), followed by Bendamustine + Rituximab (BR) (N=34, 22.7%), Fludarabine + Cyclophosphamide + Rituximab (FCR) (N=18, 12.0%), and Chlorambucil + Obinutuzumab (Clb+O) (N=10, 6.7%), in comparison to previous years (2010-2020) where chemotherapy regimens FCR, CLB+O and BR are amongst the most common. HCRU within the first year of treatment was similar amongst any 1L FD regimen, however, targeted therapies (V+O) had fewer outpatients visits (1.2) on average than those on FD chemotherapy regimen (5.4). Median duration of any 1L FD therapy was 5.8 months, median rwOS was 12 years, and median TTNT was 39.6 months.
CONCLUSIONS: Study results characterize the current CLL 1L FD treatment landscape in Alberta. A rapid treatment shift towards targeted FD therapies over chemotherapy regimens supports the development of further 1L FD therapies for CLL management.
METHODS: An observational study was conducted with health administrative data from Alberta, Canada. The study population includes adult patients diagnosed with CLL between January 1, 2010, and December 31, 2022, and who initiated FD therapy in a first-line (1L) setting between January 1, 2010 and December 31, 2023.
RESULTS: 589 CLL patients were identified; 69.9 % were male, and median age (at diagnosis) was 65 years. In recent years (2021-2023), a majority of patients received Venetoclax + Obinutuzumab (V+O) (N=88, 58.7%), followed by Bendamustine + Rituximab (BR) (N=34, 22.7%), Fludarabine + Cyclophosphamide + Rituximab (FCR) (N=18, 12.0%), and Chlorambucil + Obinutuzumab (Clb+O) (N=10, 6.7%), in comparison to previous years (2010-2020) where chemotherapy regimens FCR, CLB+O and BR are amongst the most common. HCRU within the first year of treatment was similar amongst any 1L FD regimen, however, targeted therapies (V+O) had fewer outpatients visits (1.2) on average than those on FD chemotherapy regimen (5.4). Median duration of any 1L FD therapy was 5.8 months, median rwOS was 12 years, and median TTNT was 39.6 months.
CONCLUSIONS: Study results characterize the current CLL 1L FD treatment landscape in Alberta. A rapid treatment shift towards targeted FD therapies over chemotherapy regimens supports the development of further 1L FD therapies for CLL management.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE410
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Oncology, STA: Multiple/Other Specialized Treatments