OBJECTIVES:

The CancerLinQ Discovery^® database, launched by the American Society of Clinical Oncology in 2016, consists of longitudinal, demographically and geographically diverse data aggregated from oncology practice electronic health records (EHR). Treatment patterns for patients with chronic lymphocytic leukemia (CLL) have changed significantly with approval of novel targeted therapies. The study objective is to generate contemporary data on treatment patterns using CancerLinQ Discovery because CLL treatment pattern data are limited in the community oncology clinic setting.

METHODS:

Adults with CLL who initiated treatment between August 1, 2013 and September 19, 2018 were identified retrospectively from EHR in CancerLinQ Discovery and followed up until September 19, 2019. Index date was the date of first CLL treatment. Baseline demographics, comorbidities and treatment characteristics were derived from structured data elements of the EHR or were extracted from clinical notes in the EHR.

RESULTS:

In total, 837 patients were included. Median age at index was 71.0 years; 62.7% were male. Of patients with a known Eastern Cooperative Oncology Group (ECOG) score at index (n=366), 44.3% and 39.6% had an ECOG performance status of 0 or 1, respectively. Comorbidities at index (≥ 5%) were hypertension (31.5%), anemia (30.1%), thrombocytopenia (15.8%), fatigue/asthenia (12.8%), renal failure (9.6%), nausea/vomiting (9.3%), neutropenia (7.6%), arrythmia (6.3%), atrial fibrillation (5.5%) and infection (5.4%). Bendamustine-rituximab (21.5%), ibrutinib (18.6%), rituximab (17.8%), chlorambucil-obinutuzumab (8.2%) and fludarabine-cyclophosphamide-rituximab (7.9%) were the most common first observed regimens. Ibrutinib was the most common therapy in the second (30.9%) and third (22.5%) observed regimens.

CONCLUSIONS:

This is the largest CLL real-world study using the CancerLinQ Discovery rapid learning environment. Analyses evaluating treatment-related adverse events and outcomes are ongoing. Additional research is needed as treatment patterns continue to evolve in CLL with increased use of novel agents.