Venetoclax-based regimens in octogenarian patients with CLL: efficacy, safety, and comparison to BTKi in a multicenter cohort

Octogenarians represent a significant fraction of patients with chronic lymphocytic leukemia (CLL) but, despite the prevalence of the disease in this age group, limited data are available on the safety and efficacy of novel drugs in this subgroup. We conducted a multicenter retrospective study enrolling 120 octogenarian patients who received venetoclax (Ven) regimens in any line. Regarding efficacy, we found Ven to perform similarly to what is reported in younger patients with CLL, with an overall response rate of 91%, a complete response rate of 44%, and median progression-free survival of 44 months. Concerning safety, we report a toxicity profile that is consistent with previous reports, with most high-grade adverse events being of hematologic or infectious nature, given that 37% and 22% of patients experienced neutropenia or infections of grade 3 or higher. As part of our study, we compared the safety and efficacy data we collected with those obtained in a comparable Bruton tyrosine kinase inhibitor (BTKi)-treated population. We found that these 2 treatments were comparable in terms of overall efficacy, barring a higher rate of complete responses with Ven; safety profiles were different among the 2 groups given that BTKi-treated patients had more cardiovascular toxicities (26% vs 4%) and Ven-treated subjects experienced more infectious events (82% vs 49%). Our data point out that Ven-based regimens are safe and effective in octogenarian patients with CLL despite their higher clinical complexity and comorbidity burden and should provide some basis for the design of prospective studies to further evaluate the optimal treatment regimen in this patient population.

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Journal
Blood Advances
Published
2025-04-16
DOI
https://doi.org/10.1182/bloodadvances.2025015818
Citations
1
Primary Topic
Chronic Lymphocytic Leukemia Research
Type
article
Field-Weighted Citation Impact
1.63

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article

Venetoclax-based regimens in octogenarian patients with CLL: efficacy, safety, and comparison to BTKi in a multicenter cohort

Myriam Foglietta, Enrico Derenzini, Candida Vitale, Isacco Ferrarini et al.
1 citations
Blood Advances
Chronic Lymphocytic Leukemia Research
1.63
article

Venetoclax-based regimens in octogenarian patients with CLL: efficacy, safety, and comparison to BTKi in a multicenter cohort

Myriam Foglietta, Enrico Derenzini, Candida Vitale, Isacco Ferrarini, Alessandra Tedeschi, Enrica Antonia Martino, Livio Trentin, Vanessa Innao, Massimo Gentile, Alessandro Sanna, Francesca Romana Mauro, Alessandro Cellini, Costantino Riemma, Riccardo Moia, Luca Laurenti, Lydia Scarfò, Ester Lovato, Alberto Fresa, Marta Coscia, Raffaella Pasquale, Francesca Cibien, Alessandro Noto, Andrea Visentin, Idanna Innocenti, Laura Ballotta, Antonio Cuneo, Lorella Orsucci, Enrico Lista, Anna Maria Frustaci, Caterina Patti, Elisa Santambrogio, Marzia Varettoni, Monia Marchetti, Francesco Angotzi, Roberto Marasca, Paolo Sportoletti, Paolo Ghia, Federica Mazzetto, Costanza Andriola, Martina Bullo, Andrea Serafin, Gianmarco Favrin, Massimo Moratti
article en
1 citations

Abstract

Octogenarians represent a significant fraction of patients with chronic lymphocytic leukemia (CLL) but, despite the prevalence of the disease in this age group, limited data are available on the safety and efficacy of novel drugs in this subgroup. We conducted a multicenter retrospective study enrolling 120 octogenarian patients who received venetoclax (Ven) regimens in any line. Regarding efficacy, we found Ven to perform similarly to what is reported in younger patients with CLL, with an overall response rate of 91%, a complete response rate of 44%, and median progression-free survival of 44 months. Concerning safety, we report a toxicity profile that is consistent with previous reports, with most high-grade adverse events being of hematologic or infectious nature, given that 37% and 22% of patients experienced neutropenia or infections of grade 3 or higher. As part of our study, we compared the safety and efficacy data we collected with those obtained in a comparable Bruton tyrosine kinase inhibitor (BTKi)-treated population. We found that these 2 treatments were comparable in terms of overall efficacy, barring a higher rate of complete responses with Ven; safety profiles were different among the 2 groups given that BTKi-treated patients had more cardiovascular toxicities (26% vs 4%) and Ven-treated subjects experienced more infectious events (82% vs 49%). Our data point out that Ven-based regimens are safe and effective in octogenarian patients with CLL despite their higher clinical complexity and comorbidity burden and should provide some basis for the design of prospective studies to further evaluate the optimal treatment regimen in this patient population.

Blood AdvancesVol. 9(14)
University of Insubria (IT), University of Verona (IT), University of Modena and Reggio Emilia (IT), Università degli Studi del Piemonte Orientale “Amedeo Avogadro” (IT), University of Padua (IT), Vita-Salute San Raffaele University (IT), University of Ferrara (IT), University of Perugia (IT), Agostino Gemelli University Polyclinic (IT), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT), Azienda Ospedaliera Citta' della Salute e della Scienza di Torino (IT), Ospedale Maggiore (IT), Ospedale Santa Chiara (IT), Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT), Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IT), Ospedale Vincenzo Cervello (IT), Azienda Ospedaliera di Cosenza (IT), Provincia Autonoma di Trento (IT), Azienda Ospedaliero-Universitaria Careggi (IT), Ospedale Santa Maria della Misericordia di Udine (IT), Arcispedale Sant'Anna (IT), Azienda Socio Sanitaria Territoriale Lariana (IT), Torino e-district (IT), A. O. Ordine Mauriziano di Torino (IT), Ospedale Annunziata di Cosenza (IT), IRCCS Ospedale San Raffaele (IT), Azienda Sanitaria Ospedaliera S.Croce e Carle Cuneo (IT), Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale" (IT), Azienda di Rilievo Nazionale ed Alta Specializzazione (IT), Ca' Foncello Hospital (IT), Policlinico San Matteo Fondazione (IT), Istituti di Ricovero e Cura a Carattere Scientifico (IT), Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo (IT), Azienda Sanitaria Universitaria Integrata di Trieste (IT), University of Calabria (IT), European Institute of Oncology (IT), Sapienza University of Rome (IT)
Bristol-Myers Squibb, Eli Lilly and Company, AstraZeneca, GlaxoSmithKline, Sanofi, Gilead Sciences, BeiGene, Università degli Studi di Padova, Associazione Italiana per la Ricerca sul Cancro, Loxo Oncology
Good health and well-being
Openalex Percentile: Top 18%
Chronic Lymphocytic Leukemia Research
1.63
DOIOpen Access PDFOpenAlex
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