Contemporary Fixed-Duration Treatment Options in the First-Line Setting of Chronic Lymphocytic Leukemia: Perspectives from a Publicly Funded Healthcare System.
Simple Summary: Contemporary drug combinations are or will soon be available for the first-line treatment of chronic lymphocytic leukemia that are provided to patients within a fixed duration. Hematologists from across Canada met to discuss the attributes of these options and share considerations fo...
| Publicado en: | Current Oncology Vol. 32; no. 10; pp. 543 - 557 |
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| Autores principales: | , , , , |
| Formato: | Journal Article |
| Publicado: |
MDPI
Oct2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=188957449&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 188957449 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 11980052 5EKK jtl: Current Oncology issn: 11980052 maglogo: N pubinfo: dt: Oct2025 vid: 32 iid: 10 pid: 97109 pub: MDPI artinfo: ui: 188957449 10.3390/curroncol32100543 188957449 ppf: 543 ppct: 14 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Contemporary Fixed-Duration Treatment Options in the First-Line Setting of Chronic Lymphocytic Leukemia: Perspectives from a Publicly Funded Healthcare System. aug: au: Lemieux, Christopher Phua, Chai W. Robinson, K. Sue Owen, Carolyn Banerji, Versha affil: Division of Hematology and Medical Oncology, Centre Intégré de Cancérologie, CHU de Québec-Université Laval, 2250 Boul. Henri-Bourassa, Québec City, QC G1J 0J9, Canada sug: ab: Simple Summary: Contemporary drug combinations are or will soon be available for the first-line treatment of chronic lymphocytic leukemia that are provided to patients within a fixed duration. Hematologists from across Canada met to discuss the attributes of these options and share considerations for their use in clinical practice. The hematologists identified many benefits related to these therapies (e.g., time off treatment, improved patient quality of life and safety, reduced cost burden), though noted that a need likely remains for continuously administered options for certain patient subgroups. They stated that new all-oral fixed-duration combinations may be particularly appealing to Canadian patients and clinicians, flagging their associated convenience and treatment equity. The hematologists also emphasized the need for shared decision-making between patients, caregivers, and clinicians to ensure informed and optimal treatment selection that acknowledges patient characteristics and goals and drug availability within a publicly funded healthcare system. First-line options for chronic lymphocytic leukemia (CLL) are evolving, recently returning to a fixed-duration (FD) approach incorporating regimens such as venetoclax + obinutuzumab, ibrutinib + venetoclax, and soon acalabrutinib + venetoclax ± obinutuzumab. Five Canadian hematologists convened to share perspectives regarding the attributes of these options and considerations for clinically appropriate integration within Canada's publicly funded healthcare system. The hematologists underscored the importance of shared decision-making with patients, family members, and caregivers involving careful consideration of disease profile and patient characteristics, preferences, and values. They indicated that although a role persists for continuous therapy with approved covalent Bruton's tyrosine kinase inhibitors (typically in high-risk disease), newer FD regimens offer multiple benefits related to the treatment-free period, quality of life, safety, re-treatment, healthcare resource utilization, and costs. The hematologists highlighted the appeal of all-oral FD combinations given their convenience and impact on treatment equity, factors especially compelling given Canada's vast geography and large segment of rural populations. In closing, they emphasized the quickly evolving therapeutic setting of CLL in the 1L and beyond, underscoring the need for ongoing patient involvement in decision-making to support optimal treatment selection based on patient goals and within the confines of provincial funding. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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