Real-world treatment patterns, discontinuation and clinical outcomes in patients with B-cell lymphoproliferative diseases treated with BTK inhibitors in China
IntroductionBruton tyrosine kinase inhibitor (BTKi) has demonstrated substantial efficacy in treating B-cell lymphoproliferative diseases (BLPD). Nonetheless, the significant discontinuation rates due to toxicity or financial reasons cannot be overlooked. In China, empirical evidence on the usage of...
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1184395/full |
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| author | Yuting Yan Yuting Yan Rui Lv Rui Lv Tingyu Wang Tingyu Wang Ying Yu Ying Yu Yanshan Huang Yanshan Huang Wenjie Xiong Wenjie Xiong Yuxi Li Yuxi Li Weiwei Sui Weiwei Sui Qi Wang Qi Wang Wenyang Huang Wenyang Huang Gang An Gang An Dehui Zou Dehui Zou Jianxiang Wang Jianxiang Wang Lugui Qiu Lugui Qiu Shuhua Yi Shuhua Yi |
| author_facet | Yuting Yan Yuting Yan Rui Lv Rui Lv Tingyu Wang Tingyu Wang Ying Yu Ying Yu Yanshan Huang Yanshan Huang Wenjie Xiong Wenjie Xiong Yuxi Li Yuxi Li Weiwei Sui Weiwei Sui Qi Wang Qi Wang Wenyang Huang Wenyang Huang Gang An Gang An Dehui Zou Dehui Zou Jianxiang Wang Jianxiang Wang Lugui Qiu Lugui Qiu Shuhua Yi Shuhua Yi |
| author_sort | Yuting Yan |
| collection | DOAJ |
| description | IntroductionBruton tyrosine kinase inhibitor (BTKi) has demonstrated substantial efficacy in treating B-cell lymphoproliferative diseases (BLPD). Nonetheless, the significant discontinuation rates due to toxicity or financial reasons cannot be overlooked. In China, empirical evidence on the usage of BTKi remains scarce.MethodsTo address this, a retrospective cohort study was conducted focused on 673 Chinese patients with BLPD who underwent at least one month of BTKi therapy.ResultsMedian age at BTKi initiation was 60 years. The median duration on BTKi treatment of the whole cohort was 36.4 months. The median post-BTK survival was not reach. BTKi-based treatment was permanently discontinued in 288 (43.8%) patients during follow-up, mostly attributed to progressive disease. Within the first 6 months of BTKi treatment, 76 patients (26.3%) had early treatment discontinuation. Patients with early discontinuation had extreme worse outcome with a median post-discontinuation survival of only 6.9 months. On multivariate analysis, withdrawal BTKi by toxicity and withdrawal BTKi within 6 months retained to be independent predictors of post-BTK survival, after taking account of the response depth, lines of therapy and baseline cytogenetics including 17p deletion. The decision between BTKi monotherapy and combination therapy, along with the preference for first or second-generation BTKi, exerted no significant impact on survival.DiscussionsThese observations contribute valuable real-world insights into the utilization of BTKi in China. We concluded that BTKi is an effective and well-tolerated treatment for long-term use in Chinese patient population. However, it is imperative to stress that a proportion of patients discontinue BTKi early, leading to suboptimal outcomes. This study underscores the importance of adherence to BTKi therapy for improved clinical outcomes in real-world patients. |
| first_indexed | 2024-03-13T00:52:29Z |
| format | Article |
| id | doaj.art-b340f631763c46bcb671dde075123c8f |
| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-03-13T00:52:29Z |
| publishDate | 2023-07-01 |
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| spelling | doaj.art-b340f631763c46bcb671dde075123c8f2023-07-07T12:08:34ZengFrontiers Media S.A.Frontiers in Immunology1664-32242023-07-011410.3389/fimmu.2023.11843951184395Real-world treatment patterns, discontinuation and clinical outcomes in patients with B-cell lymphoproliferative diseases treated with BTK inhibitors in ChinaYuting Yan0Yuting Yan1Rui Lv2Rui Lv3Tingyu Wang4Tingyu Wang5Ying Yu6Ying Yu7Yanshan Huang8Yanshan Huang9Wenjie Xiong10Wenjie Xiong11Yuxi Li12Yuxi Li13Weiwei Sui14Weiwei Sui15Qi Wang16Qi Wang17Wenyang Huang18Wenyang Huang19Gang An20Gang An21Dehui Zou22Dehui Zou23Jianxiang Wang24Jianxiang Wang25Lugui Qiu26Lugui Qiu27Shuhua Yi28Shuhua Yi29State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaIntroductionBruton tyrosine kinase inhibitor (BTKi) has demonstrated substantial efficacy in treating B-cell lymphoproliferative diseases (BLPD). Nonetheless, the significant discontinuation rates due to toxicity or financial reasons cannot be overlooked. In China, empirical evidence on the usage of BTKi remains scarce.MethodsTo address this, a retrospective cohort study was conducted focused on 673 Chinese patients with BLPD who underwent at least one month of BTKi therapy.ResultsMedian age at BTKi initiation was 60 years. The median duration on BTKi treatment of the whole cohort was 36.4 months. The median post-BTK survival was not reach. BTKi-based treatment was permanently discontinued in 288 (43.8%) patients during follow-up, mostly attributed to progressive disease. Within the first 6 months of BTKi treatment, 76 patients (26.3%) had early treatment discontinuation. Patients with early discontinuation had extreme worse outcome with a median post-discontinuation survival of only 6.9 months. On multivariate analysis, withdrawal BTKi by toxicity and withdrawal BTKi within 6 months retained to be independent predictors of post-BTK survival, after taking account of the response depth, lines of therapy and baseline cytogenetics including 17p deletion. The decision between BTKi monotherapy and combination therapy, along with the preference for first or second-generation BTKi, exerted no significant impact on survival.DiscussionsThese observations contribute valuable real-world insights into the utilization of BTKi in China. We concluded that BTKi is an effective and well-tolerated treatment for long-term use in Chinese patient population. However, it is imperative to stress that a proportion of patients discontinue BTKi early, leading to suboptimal outcomes. This study underscores the importance of adherence to BTKi therapy for improved clinical outcomes in real-world patients.https://www.frontiersin.org/articles/10.3389/fimmu.2023.1184395/fulltreatment patternsadverse eventsBTK inhibitordiscontinuationoutcome |
| spellingShingle | Yuting Yan Yuting Yan Rui Lv Rui Lv Tingyu Wang Tingyu Wang Ying Yu Ying Yu Yanshan Huang Yanshan Huang Wenjie Xiong Wenjie Xiong Yuxi Li Yuxi Li Weiwei Sui Weiwei Sui Qi Wang Qi Wang Wenyang Huang Wenyang Huang Gang An Gang An Dehui Zou Dehui Zou Jianxiang Wang Jianxiang Wang Lugui Qiu Lugui Qiu Shuhua Yi Shuhua Yi Real-world treatment patterns, discontinuation and clinical outcomes in patients with B-cell lymphoproliferative diseases treated with BTK inhibitors in China Frontiers in Immunology treatment patterns adverse events BTK inhibitor discontinuation outcome |
| title | Real-world treatment patterns, discontinuation and clinical outcomes in patients with B-cell lymphoproliferative diseases treated with BTK inhibitors in China |
| title_full | Real-world treatment patterns, discontinuation and clinical outcomes in patients with B-cell lymphoproliferative diseases treated with BTK inhibitors in China |
| title_fullStr | Real-world treatment patterns, discontinuation and clinical outcomes in patients with B-cell lymphoproliferative diseases treated with BTK inhibitors in China |
| title_full_unstemmed | Real-world treatment patterns, discontinuation and clinical outcomes in patients with B-cell lymphoproliferative diseases treated with BTK inhibitors in China |
| title_short | Real-world treatment patterns, discontinuation and clinical outcomes in patients with B-cell lymphoproliferative diseases treated with BTK inhibitors in China |
| title_sort | real world treatment patterns discontinuation and clinical outcomes in patients with b cell lymphoproliferative diseases treated with btk inhibitors in china |
| topic | treatment patterns adverse events BTK inhibitor discontinuation outcome |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1184395/full |
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