REAL-WORLD LINE-OF-THERAPY ATTRITION IN CHRONIC LYMPHOCYTIC LEUKEMIA ACROSS FIVE EUROPEAN COUNTRIES: EVIDENCE FROM THE CANCERMPACT® 2026 PHYSICIAN SURVEY
Author(s)
Goran Bencina, PhD1, Emanuele Guardalben, PhD1, Joshua Lankin, PhD2, Otavio Clark, PhD2.
1Eli Lilly and Company, Indianapolis, IN, USA, 2Oracle Life Sciences, Austin, TX, USA.
1Eli Lilly and Company, Indianapolis, IN, USA, 2Oracle Life Sciences, Austin, TX, USA.
OBJECTIVES: Targeted therapies have significantly improved survival in patients with chronic lymphocytic leukemia (CLL), but real-world data on proportions of patients with CLL advancing through successive lines of treatment (LoT) are limited. This cross-sectional, observational study quantified cumulative attrition LoT rates in CLL across the EU5 (Germany, France, Italy, Spain, and the United Kingdom).
METHODS: Data were derived from the CancerMPact® Treatment Architecture EU5 2026 physician survey (Oracle Life Sciences), conducted in February 2026. Hematology/oncology physicians (N=107) reported outcomes for 6,983 patients representing their total monthly CLL volume seen on active treatment over the preceding 12 months. For each LoT, physicians estimated the proportion of patients: a) progressing to the next LoT, b) achieving long-term remission while remaining on treatment, c) dying before the next LoT due to any cause, or d) remaining alive without further active treatment. Cumulative attrition was calculated as a weighted average overall and stratified by del17p/TP53 mutation status and fitness status (fit or unfit/poor performance status).
RESULTS: Overall, 58% of drug-treated patients received only 1LoT, 26% only 2LoT, 11% 3LoT, and 5% reached 4LoT. Attrition varied by subgroup: advancing from 1L to 2L ranged from 37% in unfit del17p/TP53 wild-type/unknown patients to 45% in del17p/TP53-mutated patients. Transitioning from 2L to 3L ranged from 37% in wild-type/unknown patients to 40% in del17p/TP53-mutated patients. Among patients stopping after 1LoT, 23-30% achieved long-term remission on treatment, 12-19% died due to any cause, and 14-16% were alive without further active treatment. At 2LoT, 22% achieved long-term remission on treatment, 22% died due to any cause, and 19% were alive without further active treatment.
CONCLUSIONS: In the EU5, the majority (84%) of drug-treated CLL patients receive ≤2LoT. These data reinforce the clinical imperative to deploy the most effective, tolerable, and patient-preferred treatments early, as many patients may never reach later lines.
METHODS: Data were derived from the CancerMPact® Treatment Architecture EU5 2026 physician survey (Oracle Life Sciences), conducted in February 2026. Hematology/oncology physicians (N=107) reported outcomes for 6,983 patients representing their total monthly CLL volume seen on active treatment over the preceding 12 months. For each LoT, physicians estimated the proportion of patients: a) progressing to the next LoT, b) achieving long-term remission while remaining on treatment, c) dying before the next LoT due to any cause, or d) remaining alive without further active treatment. Cumulative attrition was calculated as a weighted average overall and stratified by del17p/TP53 mutation status and fitness status (fit or unfit/poor performance status).
RESULTS: Overall, 58% of drug-treated patients received only 1LoT, 26% only 2LoT, 11% 3LoT, and 5% reached 4LoT. Attrition varied by subgroup: advancing from 1L to 2L ranged from 37% in unfit del17p/TP53 wild-type/unknown patients to 45% in del17p/TP53-mutated patients. Transitioning from 2L to 3L ranged from 37% in wild-type/unknown patients to 40% in del17p/TP53-mutated patients. Among patients stopping after 1LoT, 23-30% achieved long-term remission on treatment, 12-19% died due to any cause, and 14-16% were alive without further active treatment. At 2LoT, 22% achieved long-term remission on treatment, 22% died due to any cause, and 19% were alive without further active treatment.
CONCLUSIONS: In the EU5, the majority (84%) of drug-treated CLL patients receive ≤2LoT. These data reinforce the clinical imperative to deploy the most effective, tolerable, and patient-preferred treatments early, as many patients may never reach later lines.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
RWD94
Topic
Real World Data & Information Systems
Disease
Oncology