Prognostic Biomarker Testing Rates Low for Patients With CLL, SLL
Prognostic biomarker testing for patients with chronic lymphocytic leukemia (CLL) or small lymphocytic leukemia (SLL) is low, indicating the need for more comprehensible treatment options, according to data presented by Kathleen Calivo, BSN, RN, OCN, Memorial Sloan Kettering Cancer Center, and colleagues, at the virtual 46th Annual Oncology Nursing Society Congress.
Calivo and colleagues used the informCLL registry, a US-based prospective, observational, multicenter registry of patients with CLL/SLL, to examine baseline characteristics, prognostic biomarker testing data, and treatment guidelines in routine clinical settings for patients with CLL/SLL. Currently, FISH testing, TP53 mutational status testing, and IGHV mutational status testing are used to guide optimal treatment decisions for patients with CLL/SLL.
From October 2015-June 2019, informCLL enrolled 1,461 eligible patients with either previously untreated CLL/SLL (59%, n = 855) or relapsed/refractory CLL/SLL (41%, n = 607) that had received an FDA-approved therapy within 45 days of enrollment. The median follow-up was 14.9 months and 15.3 months among previously untreated patients and R/R patients, respectively. The majority of patients (88%) had an Eastern Cooperative Oncology Group (ECOG) performance score of 0 or 1.
For all patients, the most common treatment was ibrutinib (46%) followed by chemoimmunotherapy (CIT; 33%), immunotherapy (13%), other novel agents (6%), and chemotherapy (1%). Most patients (87%) began ibrutinib therapy at the recommended daily dose (420 mg) and did not require dose modifications (75%).
The median cycles received for patients completing CIT treatment were 5 (bendamustine plus rituximab), 5 (fludarabine, cyclophosphamide, rituximab), and 6 (obinutuzmab plus chlorambucil).
Overall, prognostic biomarker testing rates were low. FISH, TP53, and IGHV tests were performed in 28% (previously untreated, 33%; R/R, 21%), 11% and 12% of patients, respectively. Among those tested by FISH, 24% had del(17p) and, of those patients, 28% were treated with CIT. Of the patients who did not undergo FISH testing, 33% were treated with CIT. Testing of the other biomarkers occurred less often.
“Results from inform CLL show ibrutinib as the most common treatment received. Prognostic biomarker testing was infrequent and patients with high-risk features received CIT despite current guidelines. Nurses can advocate for prognostic biomarker testing and help to close a ‘knowledge gap’ by educating patients on the importance of prognostic biomarker testing,” concluded Calivo et al.—Emily Bader
Calivo K, Brisley A, Han J, et al. Real-World Prognostic Biomarker Testing and Nursing Experience from the Prospective Observational Registry informCLL for Patients Receiving Treatment for Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma. Presented at: the 46th Annual Oncology Nursing Society Congress; April 20, 22, 27, and 29, 2021; virtual. Abstract 8848.