OBJECTIVES: Several factors including disease status, patient preferences and efficacy profiles inform optimal treatment choice for patients with CLL/SLL. This study assesses physicians’ perception and rationales for treatment choices in patients with CLL/SLL in the US.

METHODS: Real-world data were drawn from the Adelphi CLL Disease-Specific Programme™, a cross-sectional survey conducted October 2022-April 2023 among hematologists and hem-oncologists across the US. Physicians completed a survey capturing their demographics, CLL/SLL treatment management and patient workload, and physicians’ reasons for choosing treatments at each line. Descriptive statistics were reported.

RESULTS: 58 physicians (95% hem-oncologists; 62% in academic/specialist centers) provided data. Physicians estimated a median (IQR) of 38% (12-51%), 20% (0-30%), and 10% (3-20%) of 1L patients receive BTKi based therapy, chemoimmunotherapy and B-cell lymphoma 2 inhibitor-based therapy, respectively.

Overall survival (OS; 72%), progression free survival (PFS; 62%) and duration of response (DOR; 47%) were the most commonly physician-reported attributes for 1L treatment choice. Of physicians who reported OS (n=42), PFS (n=36) or DOR (n=27) as a consideration for 1L treatment choice, n=26, n=9 and n=17 cited those attributes as their most important consideration, respectively.

Physicians provided data on factors informing their prescribing preferences in their patient population. Of all the responses for BTKi as a class, clinical data (57%) was the top reason for prescribing BTKis. Of the 57 responses provided by physicians for ibrutinib, 34 respondents (60%) indicated that 1L was the preferred line of therapy; clinical data (63%) was the main reason for prescribing ibrutinib.

CONCLUSIONS: Overall survival was the most widely reported and important factor among physicians when considering 1L CLL/SLL treatment. Within the BTKi class, clinical data was the most common reason for choosing a treatment in the 1L setting. Additional studies are needed to characterize any further changes in physicians’ perception and practice patterns over time.