Abstract：
Real-world evidence comparing clinical outcomes between venetoclax and Bruton tyrosine kinase inhibitors (BTKis) in patients with frontline (1 L) chronic lymphocytic leukaemia (CLL) is lacking. We compared treatment effectiveness of 1 L venetoclax plus obinutuzumab (VenO) versus BTKi-based regimens. This retrospective observational study using Optum Clinformatics Data Mart® included adult patients with CLL (≥2 outpatient or ≥1 inpatient claim) who received VenO or BTKi-based regimens in 1 L (1/2019-9/2022). Baseline characteristics were balanced using stabilised inverse probability weighting. Outcomes included duration of therapy (DoT), persistence, time to next treatment or death (TTNT-D), and time off-treatment. Among 1506 eligible patients (VenO: 203; BTKi: 1303), the median follow-up duration was 12.6 (VenO) and 16.2 months (BTKi). Median DoT for VenO was 12.3 months; persistence remained higher in VenO versus BTKi through expected 1 L fixed treatment duration. Median TTNT-D was not reached for VenO; however, more VenO- versus BTKi-treated patients had not switched therapies/experienced death through Month 12 (87.1% vs. 75.3%). Among patients that discontinued, median time to discontinuation was 11.7 vs. 5.9 months for VenO versus BTKi and median time off-treatment was 11.3 vs. 4.3 months. In this real-world study, VenO was associated with better effectiveness outcomes than BTKi-based regimens in 1 L CLL.
摘要：
缺乏比较Venetoclax和Bruton酪氨酸激酶抑制剂（BTKis）在一线（1L）慢性淋巴细胞白血病（CLL）患者中的临床结果的现实证据。我们比较了1Lvenetoclax联合obinutuzumab（VenO）与基于BTKi的方案的治疗效果。这项使用OptumClinformaticsDataMart®的回顾性观察性研究包括在1L（1/2019-9/2022）中接受基于VenO或BTKi的方案的CLL成年患者（≥2名门诊或≥1名住院患者）。使用稳定的逆概率加权来平衡基线特征。结果包括治疗持续时间（DoT），持久性,下一次治疗或死亡的时间（TTNT-D），和时间离开治疗。在1506名符合条件的患者中（VenO：203；BTKi：1303），中位随访时间为12.6个月(VenO)和16.2个月(BTKi).VenO的平均DoT为12.3个月；通过预期的1L固定治疗持续时间，VenO的持久性仍高于BTKi。VenO未达到TTNT-D的中位数；然而，与BTKi相比，接受VenO治疗的患者在第12个月内没有转换治疗/经历死亡（87.1％与75.3%）。在停药的患者中，中位停药时间为11.7vs.VenO与BTKi的5.9个月，中位治疗时间为11.3vs.4.3个月。在现实世界的研究中,在1LCLL中，与基于BTKi的方案相比，VenO与更好的疗效结果相关。
