iwCLL 2025 | FIRST-CLL study: identifying factors influencing the choice of first-line treatment regimen in CLL

Nowadays we have so many options for first-line patients with CLL and in the absence of mature head-to-head data comparisons it could be difficult for a physician to choose the best option for each patient. So we would like to design a study aiming at evaluating which are the main determinants that guide the decision-making of first-line treatment for CLL patients. 

For these reasons, we enrolled more than 130 patients from nine centers of Italy that started first-line treatment outside of clinical trials. And for each patient, we asked the treating physician to score from one to five the importance of different parameters that could lead the treatment choice. For instance, age of the patients, comorbidities or disease-related factors such as high-risk features or the route and timing of administration of the therapy, fixed-duration versus continuous therapy, oral therapy versus IV therapies, and of course patient preference, which is a factor that is growing in importance. 

We analyzed lots of factors, and TLS risk and lymph node size are not as much important as they were in the past. So main factors nowadays, at least in the Italian scenario, seem to be patient age and comorbidities, patient preference, which is a strong factor, as well as the modality of routes and administration of the treatment such as IV versus oral, and of course the timing of the administration. So I think that this study will help physicians to choose the best treatment for CLL patients for sure, because I think it’s growing up the importance of patient-directed therapy. I mean to go into a very personalized treatment for patients.

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