334MO - A multicenter retrospective study to understand the clinical characteristics, treatment patterns, and outcomes of CLL patients in the Middle East: A subgroup analysis of the CREEK study

Background

Given the progressive nature of CLL and scarce evidence from the Middle East (ME), the CREEK study investigated the clinical characteristics, treatment patterns, and outcomes among CLL-naïve (CLL-N) or CLL-treated (CLL-Tx).

Methods

Data from 1009 patients were collected retrospectively from June 2016 to March 2023 from 17 ME, Asia Pacific, and Latin America countries. A subgroup analysis of 565 patients (442 CLL-Tx for at least 12 months and 123 CLL-N) in five ME countries was conducted. Patient and disease characteristics, treatment patterns, responses, adverse events (AEs), and medical resource utilization (MRU) were recorded.

Results

The average ages for CLL-Tx and CLL-N were 61.1 and 63.5 years. According to the ECOG score, 42.3% CLL-N and 22.2% CLL-Tx were fully active at diagnosis. CLL-Tx showed advanced staging based on Rai and Binet Scores (p<0.0001). The IGHV testing rate was 20.8% in CLL-Tx, and 39.8% in CLL-N groups. Of all patients, unmutated IGHV was observed in 14.0% vs. 10.6%, respectively. TP53 aberrations were detected in 9.0% of CLL-Tx and 9.8% of CLL-N groups. Del(17p) and del(11q) were observed in 12.4% and 9.0% of CLL-Tx, and 11.4% and 13.8% of CLL-N, respectively. Among CLL-Tx, 76.0% received chemo-immunotherapies (CIT), and 18.3% received targeted therapies. AEs were 24.2% for CIT and 7.5% for targeted therapy. CLL-Tx mortality was 6.1%, with a mean OS of 94.54-month. CIT had a mean PFS of 10.9-month, while targeted therapy had 9.2 months, with the mean time to treatment failure (TTF) was 7.1 and 4.7 months, respectively. Targeted therapy led to fewer number of hospitalizations (0.8±1.5 vs. 1.3±2.2) and transfusions (10.8% vs. 19.2%), with comparable stays and ER visits. In the GCC, CLL-Tx mortality was 1.7%, with 102.2-month OS and no progression. TTF was 7.5 months for CIT and 4.4 for targeted therapy.

Conclusions

The CREEK study revealed a low proportion of patients being stratified by risk factors, along with suboptimal treatment outcomes in real-world practice, as evidenced by poor PFS and TTF. CIT is associated with a higher proportion of AEs and MRU than targeted therapies, highlighting the need for tailored approaches to improve CLL outcomes.

Clinical trial identification

Editorial acknowledgement

Many thanks to CTI MEA for their statistical and editorial assistance.

Legal entity responsible for the study

AstraZeneca.

Funding

AstraZeneca.

Disclosure

All authors have declared no conflicts of interest.