Second cancer incidence in CLL patients receiving BTK inhibitors
| العنوان: | Second cancer incidence in CLL patients receiving BTK inhibitors |
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| المؤلفون: | Ying Huang, James L. Fisher, Erin M. Bertino, Samantha Jaglowski, Kami J. Maddocks, Seema A. Bhat, John C. Byrd, Amy S. Ruppert, David A. Bond, Michael R. Grever, Dwight H. Owen, Jennifer A. Woyach, Kerry A. Rogers |
| المصدر: | Leukemia |
| بيانات النشر: | Springer Science and Business Media LLC, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Male, 0301 basic medicine, Oncology, Cancer Research, Chronic lymphocytic leukemia, chemistry.chemical_compound, 0302 clinical medicine, immune system diseases, Risk Factors, hemic and lymphatic diseases, Cumulative incidence, Young adult, Aged, 80 and over, education.field_of_study, immunosuppression, Incidence, Incidence (epidemiology), Second cancer, Neoplasms, Second Primary, General Medicine, Second primary cancer, Hematology, Middle Aged, Protein-Tyrosine Kinases, second cancers, Pyrazines, 030220 oncology & carcinogenesis, Ibrutinib, Benzamides, Female, Adult, medicine.medical_specialty, Population, Article, Young Adult, 03 medical and health sciences, ibrutinib, Internal medicine, medicine, Humans, education, neoplasms, Protein Kinase Inhibitors, Aged, Retrospective Studies, Btk inhibitors, business.industry, acalabrutinib, fungi, Retrospective cohort study, medicine.disease, Leukemia, Lymphocytic, Chronic, B-Cell, Increased risk, 030104 developmental biology, chemistry, chronic lymphocytic leukemia, Skin cancer, business, 030215 immunology |
| الوصف: | 7511 Background: Patients (pts) with chronic lymphocytic leukemia (CLL) suffer morbidity and mortality from CLL and increased risk for second primary neoplasia (SPN). BTK inhibitors (BTKi) are highly effective for the treatment (tx) of CLL and are associated with partial restoration of immune function with ongoing tx. The impact of BTKi on the risk for and patterns of SPN is yet to be characterized. Methods: CLL pts treated with ibrutinib or acalabrutinib at our center were identified retrospectively. Baseline (bl) and outcome data were collected including incidence (inc) of Richter’s transformation (RT), non-melanoma skin cancer (NMSC), and SPN. Standard inc ratio (SIR) with 95% confidence intervals (CI) were calculated using expected inc rates from the Surveillance, Epidemiology, and End Results Program, assuming a Poisson distribution for the observed inc. Cumulative inc (CIR) of SPN (excluding RT and NMSC) was calculated from BTKi start date to the diagnosis of SPN; death was a competing risk and pts without event were censored at last follow-up (f/u). SPN was correlated with bl data using the Fine-Gray model. Results: 691 pts were included; median age was 64 years (y), median prior lines of treatment (tx) was 2 (20% tx-naïve, 66% with prior chemo-immunotherapy), and 56% were never smokers. At median f/u of 44 months, 68 pts (10%) were diagnosed (dx) with SPN (SIR 2.4, CI 1.9-3.0) including 13 lung (SIR 3.2, CI 1.7-5.5), 9 melanoma (SIR 6.9, CI 3.1-13), 9 prostate (SIR 1.4, CI 0.6-2.6), 7 bladder (SIR 5.2, CI 2.1-10.6) cancers. CIR of SPN at 3 y was 7.6% (Table). Smoking (hazard ratio (HR) 2.9, CI 1.7-5.0, p < .01) and low bl CD8 count (HR 0.9 for 2-fold increase, CI 0.8-0.9, p < .01) were associated with higher inc of SPN. RT was dx in 58 pts (8%) and NMSC in 138 pts (20%). 179 pts had died with 3 y overall survival of 79% (CI 76-82); the most common causes of death were CLL/RT (57%) and SPN (13%). Conclusions: The inc of SPN in pts treated with BTKi for CLL is increased relative to the general population. With a 5 y CIR of NMSC and SPN of 23% and 12%, these data support consideration of intensive cancer screening for CLL pts receiving BTKi. [Table: see text] |
| تدمد: | 1476-5551 0887-6924 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1985169be02553976f5bae5031152c31Test https://doi.org/10.1038/s41375-020-0987-6Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....1985169be02553976f5bae5031152c31 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14765551 08876924 |
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