Factors influencing front line treatment of chronic lymphocytic leukemia: A French real‐world study
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Real-world data are an essential complement to clinical trials. This is particularly true for chronic lymphocytic leukemia, where five first-line options have never been directly compared. METHODS: The authors present the results of a national multicenter real-world study focusing on treatment choices in frontline chronic lymphocytic leukemia (CLL) and the criteria underlying this choice. Patients' medical records were included over a 6-month period in 25 centers. RESULTS: The majority of patients received obinutuzumab and venetoclax, especially those with mutated IGHV status. Patients harboring TP53 alterations were almost all treated with Bruton tyrosine kinase inhibitors, with a preference for zanubrutinib. Patients initiated on continuous Bruton tyrosine kinase inhibitors (BTKi) regimens were significantly older; second-generation BTKi, acalabrutinib and zanubrutinib were mostly prescribed. The most cited choice criteria by physicians were genetic prognostic factors, followed by fixed treatment duration and patient logistics considerations. Multiple correspondence analysis and unsupervised hierarchical clustering analysis allowed to identify two distinct patient profiles: younger patients, mostly with mutated IGHV status, who were mainly treated with combined drug regimens due to their fixed duration, and older patients, largely treated with BTKi because of the possibility of outpatient management. CONCLUSION: This study is the first to report real-world evidence on treatment choice in first-line CLL and highlight two distinct groups of patients.
Source: Cancer
DOI: 10.1002/cncr.70406
Authors: Arthur Coste, Nanthara Sritharan, Anne Lok, Cécile Tomowiak, Emmanuelle Ferrant, Aline Clavert, Damien Roos‐Weil, Florian Bouclet, Adrien Caillet, Carolyne Croizier, Nicolas Stocker, Emmanuelle Tchernonog, Pierre Feugier, Alberto Santagostino, Bénédicte Hivert, Anne‐Sophie Michallet, Sophie De Guibert, Diane Lara, Agathe Waultier‐Rascalou, Fatiha Merabet, Amandine Durand, Lucile Bussot, Kamel Laribi, Marie‐sarah Dilhuydy, Vincent Lévy, Anne Quinquenel
Institutions: Centre Hospitalier Universitaire de Reims, Université de Reims Champagne-Ardenne, Université Sorbonne Paris Nord, Hôpital Avicenne, Centre Hospitalier Universitaire de Nantes, Centre Hospitalier Universitaire de Poitiers, Hospices Civils de Lyon, Hôpital Lyon Sud, Centre Hospitalier Universitaire d'Angers, Sorbonne Université, Pitié-Salpêtrière Hospital, Laboratoire d'hématologie, Centre Henri Becquerel, Centre Hospitalier Universitaire de Besançon, Centre Hospitalier Universitaire de Clermont-Ferrand, Assistance Publique – Hôpitaux de Paris, Hôpital Saint-Antoine, Centre Hospitalier Universitaire de Montpellier, Centre Hospitalier Régional et Universitaire de Nancy, Centre Hospitalier de Troyes, Centre Léon Bérard, Hôpital Pontchaillou, Centre Hospitalier Universitaire de Rennes, Centre Hospitalier Universitaire de Nîmes, Centre Hospitalier de Versailles, CHU Dijon Bourgogne, Centre Hospitalier Universitaire de Grenoble, Centre Hospitalier du Mans, Centre Hospitalier Universitaire de Bordeaux, Immuno-Régulation des Maladies Auto- immunes Inflammatoires et Cancer
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,790
OpenAlex ID: W7154504372