Utilizing Real-World Evidence (RWE) to Improve Care in Chronic Lymphocytic Leukemia: Challenges and Opportunities

Curr Hematol Malig Rep. 2020 Aug;15(4):254-260. doi: 10.1007/s11899-020-00584-3.

Abstract

Purpose of review: This review discusses important findings from real-world evidence (RWE) studies impacting the field of chronic lymphocytic leukemia (CLL), from prognostication to long-term management and sequencing of novel agents.

Recent findings: RWE data, which represents a heterogeneous cohort of patients treated at non-academic centers and off-clinical trial, demonstrate several key differences between findings in randomized controlled trials (RCT) of novel agents in CLL. While toxicity and discontinuation rates are higher, survival outcomes are encouraging in clinical practice, with often equivalent outcomes from reduced-dose or time-limited therapy of drug. Though sequencing of novel agents lacks robust RCT data, RWE data provide important guidance for selection and sequencing of novel agents. RWE has critically informed our practice by providing diverse patient data and real-time analysis for important clinical questions outpacing the rapidly growing field of CLL.

Keywords: BCL-2 inhibitor; Bruton’s tyrosine kinase inhibitor; Chronic lymphocytic leukemia; Novel agents; PI3K inhibitor; Real-world evidence; Small-molecule inhibitor.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use*
  • Evidence-Based Medicine / standards*
  • Hematology / standards*
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / diagnosis
  • Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy*
  • Leukemia, Lymphocytic, Chronic, B-Cell / mortality
  • Medical Oncology / standards*
  • Molecular Targeted Therapy / adverse effects
  • Molecular Targeted Therapy / standards*
  • Quality Improvement / standards*
  • Quality Indicators, Health Care / standards*
  • Treatment Outcome

Substances

  • Antineoplastic Agents