Andorsky on the Shifting Treatment Landscape of BTKi Use in CLL/SLL

David J. Andorsky, MD, medical oncologist and hematologist, Rocky Mountain Cancer Centers, associate chair, US Oncology Hematology Research, discusses findings from a retrospective study of adult patients with chronic lymphocytic leukemia or small lymphocytic lymphoma (CLL/SLL) from ASH 2023.

In the study, patients with CLL/SLL who were treated with a Bruton's tyrosine kinase inhibitor (BTK) inhibitor between January 1, 2020, to April 30, 2023, in The US Oncology Network were evaluated to assess their treatment patterns and social determinants of health in a large network of community oncology practices..

According to Andorsky, these findings revealed that there is a shift in the BTK inhibitors being used among patients with CLL/SLL as the use of ibrutinib (Imbruvica) decreased during the observation period of the study while acalabrutinib (Calquence) and zanubrutinib (Brukinsa) increased.

Transcription:

0:09 | We observed 2 things in this publication. The first was that over time, there was less use of ibrutinib, which was the first BTK inhibitor in the market, and more use of the second generation inhibitors, acalabrutinib and zanubrutinib. I think this is a positive development because the newer drugs are more specific for the BTK protein, they have fewer [adverse] effects on average, and they are probably equally efficacious. But the [adverse] effect profile matters a lot to patients because people want to have these drugs for months, if not years, so that was 1 temporal trend we observed from 2020 through 2023.

0:41 | The second thing we observed is that there really was not a big impact of the social determinants of health on which BTK inhibitor patients received. You might have thought that patients who live in rural environments or economically deprived environments or had a government payer maybe would get inferior treatment, or at least an earlier treatment in the form of redundant but we didn't see that. We really saw that there was no association there, which I took to mean that patients were getting the treatment that they and their doctor thought were the right treatment for them.

REFERENCE

Andorsky DJ, Zackon I, Wilson TW, et al. Recent patterns of care with BTK inhibitors and distribution of social determinants of health among patients with CLL/SLL in the US community setting. Blood (2023) 142 (Suppl 1): 2413. doi: 10.1182/blood-2023-172880