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Factors Identified for Risk of Second Cancer in CLL Following BTK Inhibition

David Bond, MD
Published Online:6:14 PM, Wed August 21, 2019

David Bond, MD, assistant professor at the Ohio State University, discusses 2 key findings from a recent study investigating the risk of developing a second cancer in patients with chronic lymphocytic leukemia (CLL) treated with a BTK inhibitor. The study analyzed 691 patients with CLL who were treated with either acalabrutinib (Calquence) or ibrutinib (Imbruvica) and developed a second primary malignancy. The rate of developing a second primary neoplasia in patients with CLL treated with this class of agents was 7.6% at 3 years.

The first correlation noted in this study was between tobacco exposure and the development of a second cancer. Bond says patients with prior tobacco exposure are known to have an increased risk of cancer development, particularly in lung cancer and bladder cancer. These results validate the importance of counseling patients with CLL on treatment with BTK inhibitors regarding tobacco.
The second correlation showed that a low CD8 count at baseline was associated with an increased risk of developing a second cancer. These data are the first to demonstrate this in CLL to date, but points to the close correlation between immune function and the risk of developing a second cancer, says Bond.

Overall, Bond concludes that these findings are interesting and warrant further investigation.
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