Authored by Dr Brian Koffman
Bottom Line:
Based on outcomes reported by patients, an increase in fatigue might predict disease progression in relapsed or refractory CLL / SLL patients on ibrutinib or zanubrutinib.
Who Performed the Research and Where Was it Presented:
Dr. Jennifer Brown of Dana Farber at Harvard presented an E-Poster at the 2024 European Hematology Association (EHA) Annual Meeting in Madrid.
Background:
Patient-reported outcomes, or PROs, are an increasingly important measure in cancer research. Fatigue is perhaps the most common symptom in chronic lymphocytic leukemia / small lymphocytic lymphoma (CLL / SLL) patients, and its worsening can be associated with worsening anemia. The aim of this research was to search for a link between reported symptom progression, such as fatigue, and progression-free survival (PFS).
Methods and Participants:
The ALPINE study compared ibrutinib and zanubrutinib in relapsed / refractory CLL / SLL. This research reexamined that data, not primarily to compare the two drugs again but to see the predictive utility of any PROs. To best do this, patient-reported fatigue and pain deterioration were quantified as discrete transient and recurrent events. A total of 604 patients were studied.
Results:
- 149 (24.8%) experienced zero recurrent fatigue events.
- 249 (41.4%), 95 (15.8%), 65 (10.8%), 33 (5.5%), 10 (1.7%), and one (0.2%) experienced one, two, three, four, five, or six fatigue events, respectively.
- Patients were excluded if they experienced no symptoms or progression by the end of the study.
- Increasing fatigue events were significantly associated with an increased risk of progression, irrespective of which treatment the patient received.
- Increasing pain deterioration was associated with an increased risk of fatigue events.
Discussion and Conclusions:
Recurrent fatigue deterioration events proved able to predict the risk of disease progression before the investigator confirmed it. This suggests PROs could be a useful early indicator of when treatment may need to be modified. Plans are to study more PROs to see if other symptoms might also be helpful. It seems patients may often know what’s going on with their bodies before labs or physical findings confirm their suspicions.
Links and Resources:
Listen to my monologue below.
Read the abstract at: PATIENT-REPORTED OUTCOME (PRO)–BASED RECURRENT SYMPTOMATIC DETERIORATION PREDICTS DISEASE PROGRESSION: RESULTS FROM THE ALPINE TRIAL
Stay strong; we are all in this together.
Brian Koffman MDCM (retired) MS Ed (he, him, his)
Co-founder, Executive VP and Chief Medical Officer
CLL Society, Inc.
