Real-world zanubrutinib treatment patterns in CLL/SLL among a curated sample of US community oncology patients with prior acalabrutinib therapy
Notice bibliographique
Résumé
Abstract Background Bruton tyrosine kinase (BTK) inhibitors have demonstrated clinical efficacy in treating chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). Zanubrutinib is a highly specific and potent next-generation BTK inhibitor designed to maximize BTK occupancy and limit off-target kinase binding. In head-to-head trials, zanubrutinib was superior to ibrutinib (ALPINE trial; hazard ratio [HR]: 0.65; 95% confidence interval [CI]: 0.49-0.86), while acalabrutinib was noninferior to ibrutinib (ELEVATE-RR trial; HR: 1.00; 95% CI: 0.79-1.27) in patients with relapsed/refractory CLL. Recent clinical data suggest that patients with CLL who were intolerant of ibrutinib or acalabrutinib and switched to zanubrutinib experienced continued or improved clinical benefit (Shadman Blood Adv. 2025). Additionally, most of the ibrutinib and acalabrutinib intolerance adverse events did not recur during zanubrutinib treatment. There is limited real-world evidence describing the patient characteristics and treatment journey for patients with CLL/SLL who initiate acalabrutinib and subsequently receive zanubrutinib. This study describes the characteristics, treatment patterns, and reasons for discontinuation among patients who had previously discontinued acalabrutinib and changed to zanubrutinib in a real-world setting. Methods The IntegraConnect PrecisionQ database, which contains electronic health records from >3 million de-identified cancer patients across >500 care sites, was used to create a retrospective cohort of CLL/SLL patients who initiated and discontinued acalabrutinib and then initiated zanubrutinib between 11/21/2019 and 11/30/2024. Patients were followed through 2/28/2025. A medical record review was conducted to identify dates of treatment initiation and discontinuation and reasons for acalabrutinib and zanubrutinib discontinuation. Results A total of 806 patients initiated acalabrutinib and subsequently received another therapy; of these, 121 patients subsequently received zanubrutinib; 102 (84.3%) changed directly from acalabrutinib to zanubrutinib, and 19 (15.7%) changed from acalabrutinib to another therapy before initiating zanubrutinib. Of the 102 patients who changed directly from acalabrutinib to zanubrutinib, 74 (72.5%) received acalabrutinib in first-line and 28 (27.5%) received acalabrutinib in second-line or later. The median duration of acalabrutinib therapy prior to zanubrutinib treatment was 5.6 months (interquartile range [IQR]: 2.1, 16.5). The median duration of zanubrutinib therapy after having received acalabrutinib was 10.7 months (IQR: 4.1, 18.8), and 59 (57.8%) patients remained on zanubrutinib at the end of the follow-up period. Overall, 53 (52.0%) patients discontinued acalabrutinib within 6 months and 68 (66.7%) discontinued within 1 year. The reasons for acalabrutinib discontinuation were toxicity (68.6%), other (11.8%), or disease progression (6.9%). A total of 43 (42.2%) patients who changed from acalabrutinib to zanubrutinib discontinued zanubrutinib at the time of data cutoff. The reasons for zanubrutinib discontinuation were toxicity (58.1%), other (7.0%), or disease progression (2.3%). Conclusion In this real-world US community oncology setting, most zanubrutinib-treated patients with prior acalabrutinib therapy had discontinued acalabrutinib within 1 year. The primary reason for acalabrutinib discontinuation was toxicity. Consistent with previous research, real-world data from across the US have demonstrated that zanubrutinib was well tolerated and maintained effectiveness in patients with CLL who had received a prior BTK inhibitor.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».