Racial Disparities Found in Patients With CLL Undergoing Targeted Therapy

In patients with chronic lymphocytic leukemia (CLL), targeted therapies significantly improve clinical outcomes and overall survival (OS) rates. Targeted therapy is often the first line of treatment for patients with CLL and entails using drugs to target specific molecules or proteins on the surface of cancer cells. Examples of targeted therapy drugs include Bruton’s tyrosine kinase inhibitors, phosphoinositide 3-kinase inhibitors, and venetoclax.

Significant racial differences in lymphoid malignancies have been reported in previous studies; however, data reporting on the racial disparities related to OS in patients with CLL receiving targeted therapy is yet to be established. Researchers at the Center for Health Outcomes and Pharmacoeconomic Research at the University of Arizona analyzed the Surveillance, Epidemiology, and End Results (SEER) registry to determine whether an association exists between CLL cause-specific death and race/ethnicity, sex, and socioeconomic status.

Neda Alrawashdh, PharmD, and Ivo Abraham, PhD, RN, presented the study at the 64th American Society of Hematology Annual Meeting and Exhibition.

The study comprised 32,701 patients aged >15 years undergoing targeted therapy from the SEER database. Variables extracted for analysis included age at diagnosis, sex, ethnicity/race, annual household income, and area of residence (eg, rural versus urban). Multivariate proportional hazard models adjusted for all variables were applied to calculate the hazard ratios of death due to CLL.

Of the patients included in the study, 61% were male and 39% were female. OS was significantly better among women, Hispanic patients, and non-Hispanic White patients compared with non-Hispanic Black (NHB) patients. Regarding the association between OS and annual income, OS was significantly lower in patients with an annual income <$64,999 compared with an annual income >$75,000. There was no significant OS difference when comparing urban and rural areas of living.

“NHB patients may have advanced disease staging at diagnosis, less access to targeted treatments, delays in treatment initiation, and different disease biology (biomarkers or genetic),” the researchers wrote. “Our study highlights the need to investigate the mechanism by which race/ethnicity interacts with disease prognostic factors and treatment factors that influence survival outcomes in CLL patients.”

Source: Alrawashdh N, Abraham I. Racial/ethnic, sex, and income disparities in overall survival (OS) in chronic lymphocytic leukemia (CLL) patients in the era of targeted therapy: Surveillance, Epidemiology, and End Results (SEER) registry analysis (2009-2019). Abstract #3600. Presented at the 64th ASH Annual Meeting and Exhibition; December 11, 2022; New Orleans, Louisiana.