Treatment Patterns and Outcomes in a Nationwide Cohort of Older and Younger Veterans with Waldenström Macroglobulinemia, 2006-2019. Chien, H., Morreall, D., Patil, V., Rasmussen, K. M., Yong, C., Li, C., Passey, D. G., Burningham, Z., Sauer, B. C., & Halwani, A. S. Cancers, April, 2021. Place: Switzerland
doi  abstract   bibtex   
Little is known about real-world treatment patterns and outcomes in Waldenström macroglobulinemia (WM) following the recent introduction of newer treatments, especially among older adults. We describe patterns of first-line (1 L) WM treatment in early (2006-2012) and modern (2013-2019) eras and report outcomes (overall response rate (ORR), overall survival (OS), progression-free survival (PFS), and adverse event (AE)-related discontinuation) in younger (≤70 years) and older (\textgreater70 years) populations. We followed 166 younger and 152 older WM patients who received 1 L treatment between January 2006 and April 2019 in the Veterans Health Administration. Median follow-up was 43.5 months (range: 0.6-147.2 months). Compared to the early era, older patients in the modern era achieved improved ORRs (early: 63.8%, modern: 72.3%) and 41% lower risk of death/progression (hazard ratio (HR) for PFS: 0.59, 95% CI (confidence interval): 0.36-0.95), with little change in AE-related discontinuation between eras (HR: 0.82, 95% CI: 0.4-1.7). In younger patients, the AE-related discontinuation risk increased almost fourfold (HR: 3.9, 95% CI: 1.1-14), whereas treatment effects did not change between eras (HR for OS: 1.4, 95% CI: 0.66-2.8; HR for PFS: 1.1, 95% CI: 0.67-1.7). Marked improvements in survival among older adults accompanied a profound shift in 1 L treatment patterns for WM.
@article{chien_treatment_2021,
	title = {Treatment {Patterns} and {Outcomes} in a {Nationwide} {Cohort} of {Older} and {Younger} {Veterans} with {Waldenström} {Macroglobulinemia}, 2006-2019.},
	volume = {13},
	issn = {2072-6694},
	doi = {10.3390/cancers13071708},
	abstract = {Little is known about real-world treatment patterns and outcomes in Waldenström macroglobulinemia (WM) following the recent introduction of newer treatments,  especially among older adults. We describe patterns of first-line (1 L) WM  treatment in early (2006-2012) and modern (2013-2019) eras and report outcomes  (overall response rate (ORR), overall survival (OS), progression-free survival  (PFS), and adverse event (AE)-related discontinuation) in younger (≤70 years) and  older ({\textgreater}70 years) populations. We followed 166 younger and 152 older WM patients  who received 1 L treatment between January 2006 and April 2019 in the Veterans  Health Administration. Median follow-up was 43.5 months (range: 0.6-147.2  months). Compared to the early era, older patients in the modern era achieved  improved ORRs (early: 63.8\%, modern: 72.3\%) and 41\% lower risk of  death/progression (hazard ratio (HR) for PFS: 0.59, 95\% CI (confidence interval):  0.36-0.95), with little change in AE-related discontinuation between eras (HR:  0.82, 95\% CI: 0.4-1.7). In younger patients, the AE-related discontinuation risk  increased almost fourfold (HR: 3.9, 95\% CI: 1.1-14), whereas treatment effects  did not change between eras (HR for OS: 1.4, 95\% CI: 0.66-2.8; HR for PFS: 1.1,  95\% CI: 0.67-1.7). Marked improvements in survival among older adults accompanied  a profound shift in 1 L treatment patterns for WM.},
	language = {eng},
	number = {7},
	journal = {Cancers},
	author = {Chien, Hsu-Chih and Morreall, Deborah and Patil, Vikas and Rasmussen, Kelli M. and Yong, Christina and Li, Chunyang and Passey, Deborah G. and Burningham, Zachary and Sauer, Brian C. and Halwani, Ahmad S.},
	month = apr,
	year = {2021},
	pmid = {33916545},
	pmcid = {PMC8038459},
	note = {Place: Switzerland},
	keywords = {age groups, older adults, rare cancer, real-world evidence, treatment outcomes, treatment patterns, Waldenström macroglobulinemia},
}

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