Prognostic testing and treatment patterns in Black patients (pts) with chronic lymphocytic leukemia (CLL) from the informCLL prospective, observational registry.

Abstract

e18559 Background: Real-world data on practice patterns in Black pts with CLL are limited. We evaluated treatment (tx) patterns and prognostic biomarker testing in Black pts enrolled in the informCLL registry. Methods: Pts who initiated FDA-approved tx for CLL/SLL (index tx) were enrolled from October 2015 to June 2019. Baseline (BL) characteristics, FISH testing rates, BL factors associated with FISH testing, and patterns of index tx are summarized by line of therapy (LOT; previously untreated [1L] and relapsed/refractory [R/R]). Results: Of 1462 enrolled pts (overall registry population), 106 (7%) were Black (Table). Community-based practices enrolled 87% of Black pts, similar to the overall population (93%). Black pts were predominantly enrolled in the South (69%). Among Black pts, median age was 66 y, 65% had ECOG status ≥1, 64% had Rai stage III-IV, and median time from diagnosis to tx on registry was 40 mo (7 mo for 1L). In the overall population, median age was 71 y, 53% had ECOG status ≥1, 51% had Rai stage III-IV, and median time from diagnosis to tx was 41 mo (19 mo for 1L). FISH testing was performed in 25% of Black pts, similar to the testing rate in the overall population (28%). In a multivariate analysis, BL factors significantly associated with FISH testing were shorter time from initial diagnosis to tx, better ECOG status, earlier LOT (1L), community practice setting, and prior malignancy (p<0.05 for all); race was not a predictive factor. As in the overall population, ibrutinib was the most frequent tx among Black pts in 1L (50%) and R/R (67%), followed by chemoimmunotherapy (CIT; 1L, 43%; R/R, 15%). In 1L pts, tx with ibrutinib generally increased over time (2016, 31%; 2017, 57%; 2018, 63%; 2019, 55%) while CIT use persisted (56%; 36%; 38%; 36%, respectively). In R/R pts, use of ibrutinib decreased over time while CIT remained consistent and tx with other novel agents increased. Conclusions: Black pts with CLL tended to be younger, with worse ECOG status, more advanced disease, and shorter time to 1L therapy than the overall informCLL registry population. While ibrutinib was the most common tx in Black pts, CIT use in 1L remained persistent. Similar to the overall registry population, prognostic testing rates were suboptimal in Black pts. These results highlight the importance of prognostic testing and the need to more closely monitor disease status in Black pts as they will tend to require initial CLL therapy more rapidly than other pts. Clinical trial information: NCT02582879. [Table: see text]