Patients with coexisting conditions or who have poor outcomes with standard therapy—a large majority of which are older adults—struggle with standard treatments for chronic and small lymphocytic leukemias. The resources below explore treatment options for older adults with these diseases.
- Ibrutinib versus Ofatumumab in Previously Treated Chronic Lymphoid Leukemia: Ofatumumab and other second-line therapies for chronic lymphoid leukemia have shown poor outcomes for patients with disease that had a short response duration to first-line therapy and or adverse cytogenetic abnormalities. So researchers compared ofatumumab with ibrutinib in a multicenter, open-label, phase III study, in previously treated patients with CLL or small lymphocytic leukemia from several subgroups—including those age 70 and older. The trial results—published in this New England Journal of Medicine article—showed that ibrutinib was superior to ofatumumab in several areas, including progression-free survival, overall survival, and response rate.
- Obinutuzumab plus Chlorambucil in Patients with CLL and Coexisting Conditions: This trial—outlined in this New England Journal of Medicine article—focused on treatment for patients with chronic lymphocytic leukemia who have coexisting conditions, which is a prevalent issue among older patients with cancer. In this study, obinutuzumab plus chlorambucil and rituximab plus chlorambucil were compared with chlorambucil alone (which had previously been a standard treatment for patients with comorbidity and poor functional status). Researchers found that both combinations improved outcomes, with obinutuzumab/chlorambucil being most beneficial.
- Idelalisib and Rituximab in Relapsed Chronic Lymphocytic Leukemia: In this New England Journal of Medicine article, researchers detail their findings from a phase III trial of standard therapy rituximab plus placebo versus rituximab plus idelalisib in patients with relapsed chronic lymphocytic leukemia with comorbidities. Older patients with cancer made up a majority of the trial participants, as they most often have coexisting conditions, which make them less likely to be able to endure standard chemotherapy. Results showed that patients in the idelalisib/rituximab arm saw increased progression-free and overall survival and response rates, compared to the control arm.