The Lynx Group

Characteristics of Patients with Mantle-Cell Lymphoma and Chronic Lymphocytic Leukemia Treated with Acalabrutinib in a US Real-World Setting

Conference Correspondent
Acalabrutinib (Calquence) was approved by the US Food and Drug Administration in October 2017 for patients with mantle-cell lymphoma (MCL) who have progressed on ≥1 previous therapies and in November 2019 for patients with chronic lymphocytic leukemia (CLL). Although insights regarding patients’ experiences with acalabrutinib during clinical trials are valuable, information about real-world clinical experience with acalabrutinib has been lacking. To address this, researchers assessed acalabrutinib use in real-world patients with MCL and CLL.

This retrospective cohort study was conducted using IQVIA’s longitudinal prescription database linked to the medical claims database. Patients aged ≥18 years with ≥1 claims for acalabrutinib in the longitudinal prescription database between November 1, 2017, and April 30, 2019, were identified. The first claim was their index date. Patients were also required to have ≥1 medical claims between November 1, 2016, and April 30, 2019, and ≥12 months of baseline data.

To create 2 mutually exclusive disease cohorts, researchers focused on patients with ≥2 diagnoses of either MCL or CLL before the index date and without diagnosis of the other cancer. Patients were excluded from analysis if there were data quality issues or if they participated in a clinical trial during the study period.

A total of 264 patients with MCL and 204 patients with CLL who received acalabrutinib were identified in the study. In both disease cohorts, the majority of patients (57.2% MCL; 59.3% CLL) were aged ≥70 years. Their average ages were 72 years in the MCL cohort and 70 years in the CLL cohort. Most patients (76.9% MCL; 59.8% CLL) were male, and more than half were commercially insured (50.4% MCL; 52.5% CLL).

In the 12-month preindex period, patients with MCL and CLL had a mean Charlson Comorbidity Index (excluding hematologic malignancies) of 1.6 and 1.4, respectively. In the MCL and CLL cohorts, hypertension (67.8% and 67.7%, respectively), other hematologic malignancies (48.9% and 52%, respectively), and infection (28% and 31.4%, respectively) were the most common comorbidities. Other common conditions for the MCL cohort were anemia and neutropenia. Arrhythmia, fatigue/asthenia, atrial fibrillation, anemia, and thrombocytopenia were common in the CLL cohort.

The study also explored previous treatment regimens and found that previous treatment with a Bruton tyrosine kinase inhibitor, namely, ibrutinib (Imbruvica), was more likely in the CLL cohort (64.7%) compared with the MCL cohort (37.9%). Patients who received previous treatment with ibrutinib were more likely to have high-risk atrial fibrillation status when they started taking acalabrutinib compared with patients who had not received ibrutinib. These patients were also more likely to have several other comorbid conditions, including hypertension and fatigue. However, in this study, reasons for ibrutinib discontinuation were not explored.

This is the first analysis of acalabrutinib use in clinical practice and the first description of characteristics of patients with MCL and CLL who were treated with this medication in the real-world setting. Future studies are expected to evaluate acalabrutinib treatment patterns’ efficacy outcomes in the clinical practice setting.

Source: Ryan K, et al. ASH Abstract 3488.

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