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iwCLL 2025 | Evaluating the risk of secondary primary malignancies in patients with CLL receiving 1L therapy
Vanthana Bharathi, MD, The University of Texas MD Anderson Cancer Center, Houston, TX, presents the findings of a real-world study evaluating the risk of secondary primary malignancies in patients with chronic lymphocytic leukemia (CLL) receiving first-line (1L) therapy. Dr Bharathi highlights that patients on chemoimmunotherapy had the highest incidence of secondary cancers when compared to those on BTK inhibitors and those in the observation arm. This interview took place at the biennial International Workshop on Chronic Lymphocytic Leukemia (iwCLL) 2025 in Krakow, Poland.
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Transcript
So we did a database analysis using the Symphony Health Solution database in collaboration with BeOne. So we categorized the patients into three groups: patients that were in the observation arm, patients that received chemoimmunotherapy, including BR, FCR, and patients that got the BTK inhibitors, either ibrutinib, acalabrutinib, or zanubrutinib. So the outcome was 24-month incidence of other cancers...
So we did a database analysis using the Symphony Health Solution database in collaboration with BeOne. So we categorized the patients into three groups: patients that were in the observation arm, patients that received chemoimmunotherapy, including BR, FCR, and patients that got the BTK inhibitors, either ibrutinib, acalabrutinib, or zanubrutinib. So the outcome was 24-month incidence of other cancers.
So we found that patients on the chemoimmunotherapy arm had the highest incidence of other cancers overall at 14%, and this was significant compared to the BTK inhibitor versus the observation arm. And when we subcategorized them based on other cancer, like solid tumors and non-melanoma solid cancers and also melanoma, we found that for melanoma and non-melanoma skin cancers the difference wasn’t that significant, but it was true for other cancers.
So these findings are important because there’s always a question in clinical practice and patients come to you like you know what’s the risk of getting secondary cancers you know with when you’re under observation or BTK inhibitors. So I think it’s relatively safe to give BTK inhibitors in patients with CLL and it’s also important to understand that patients in the chemoimmunotherapy arm have increased risk of other cancers, because we need to follow them very closely and do more preventive care like screening them for other cancers, routine cancers, which is going to be my next poster that I’ll be talking about. So yeah, these are really important findings and really applicable to clinical practice.
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