Factors influencing front line treatment of chronic lymphocytic leukemia: A French real‐world study

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.

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Journal
Cancer
Published
2026-04-15
DOI
https://doi.org/10.1002/cncr.70406
Primary Topic
Chronic Lymphocytic Leukemia Research
Type
article
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article

Factors influencing front line treatment of chronic lymphocytic leukemia: A French real‐world study

Sophie de Guibert, Bénédicte Hivert, Nanthara Sritharan, Diane Lara et al.
Cancer
Chronic Lymphocytic Leukemia Research
article

Factors influencing front line treatment of chronic lymphocytic leukemia: A French real‐world study

Sophie de Guibert, Bénédicte Hivert, Nanthara Sritharan, Diane Lara, Cécile Tomowiak, Emmanuelle Tchernonog, Florian Bouclet, Arthur Coste, Agathe Waultier‐Rascalou, Vincent Lévy, Anne Quinquenel, Aline Clavert, Adrien Caillet, Fatiha Merabet, Nicolas Stocker, Anne Lok, Emmanuelle Ferrant, Carolyne Croizier, K Laribi, Alberto Santagostino, Amandine Durand, Anne‐Sophie Michallet, Lucile Bussot, Damien Roos‐Weil, Pierre Feugier, Marie‐sarah Dilhuydy
article en

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.

CancerVol. 132(8)
Centre Hospitalier Universitaire de Grenoble (FR), Centre Hospitalier Universitaire de Bordeaux (FR), Centre Hospitalier Universitaire de Nantes (FR), Sorbonne Université (FR), Centre Hospitalier Universitaire de Besançon (FR), Université Sorbonne Paris Nord (FR), Centre Hospitalier Régional et Universitaire de Nancy (FR), Hospices Civils de Lyon (FR), Clinique du Millénaire (FR), Hôpital Saint-Antoine (FR), Centre Hospitalier Universitaire de Nîmes (FR), Centre Léon Bérard (FR), Centre Hospitalier Universitaire de Reims (FR), Centre Hospitalier Universitaire de Poitiers (FR), Centre Hospitalier Universitaire d'Angers (FR), Hôpital Lyon Sud (FR), CHU Dijon Bourgogne (FR), Pitié-Salpêtrière Hospital (FR), Centre Hospitalier de Troyes (FR), Hôpital Pontchaillou (FR), Centre Hospitalier du Mans (FR), Centre d'Investigation Clinique de Nantes (FR), Centre Hospitalier Universitaire de Clermont-Ferrand (FR), Hôpital Avicenne (FR), Association Clinique et Thérapeutique Infantile du Val de Marne (FR), Laboratoire National Henri Becquerel (FR), Institut Universitaire de Recherche Clinique (FR), Centre Hospitalier Universitaire de Rennes (FR), Centre Hospitalier de Versailles (FR), Hôpital Saint-Vincent-de-Paul (FR), Université de Reims Champagne-Ardenne (FR)
Openalex Percentile: Top 19%
Chronic Lymphocytic Leukemia Research
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