PICAROS - Acalabrutinib RWE on 1L CLL in Spain

Proportion of patients on acalabrutinib therapy at 24 months after treatment initiation (cohort 1).

In addition to this outcome measured in the overall cohort, it will also be assessed by the following factors:

• the reason for treatment initiation (i.e., first-line treatment-naïve patients, and those switching due to intolerance in absence of progression),
• presence/absence of risk factors (i.e., del17p, TP53 mutation, and unmutated IGHV).
• cardiovascular comorbidities (yes/no).

rwORR (i.e., the proportion of patients that achieved complete or partial response) achieved until the end of the observational period for first-line fixed-duration acalabrutinib therapy as assessed by the treating physician (cohort 2). Complete response may include complete response, complete response with incomplete marrow recovery, or unconfirmed complete response (marrow biopsy not performed). Partial response may include partial response, or partial response with lymphocytosis. The rwORR will be assessed by the treating physician in routine clinical practice, including the use or not of the 2018 International Workshop on Chronic Lymphocytic Leukemia (iwCLL) criteria. The end of observational period for first-line fixed-duration combinations of acalabrutinib is defined as the start date of a subsequent line therapy or study end date, whichever comes first.

Acalabrutinib±venetoclax doses (e.g., starting does and dose adjustments), overall (cohorts 1 and 2) and by the reason for treatment initiation (i.e., first-line treatment-naïve patients, and those switching due to intolerance in absence of progression) (cohort 1 only).

In cohort 2, doses (e.g., starting dose, dose adjustments, maximum dose achieved) and reasons for changes within the acalabrutinib±venetoclax fixed-duration regimen will also be described globally and for each drug separately, as well as the time to reach the maximal dose.

Acalabrutinib±venetoclax dose adjustments, temporary interruptions, and permanent discontinuations, overall (cohorts 1 and 2) and by the reason for treatment initiation (i.e., first-line treatment-naïve patients, and those switching due to intolerance in absence of progression) (cohort 1 only).

In patients with regimen modifications within cohort 2, the proportion of patients with these regimen modifications and the time from treatment initiation to the regimen modification within same line therapy prior to progression (e.g., treatment duration and number of cycles prior to the modification, and reason for the modification). In cohort 2, temporary interruptions, permanent discontinuations, and their reasons for changes within the acalabrutinib±venetoclax fixed-duration regimen will also be described globally and for each drug separately, as well as the proportion of patients requiring dose reductions after achieving maximum dose.

Treatment duration (cohorts 1 and 2), overall and by the reason for treatment initiation (i.e., first-line treatment-naïve patients, and those switching due to intolerance in absence of progression) (cohort 1 only).

In cohort 2, also median number of completed cycles and the proportion of patients who complete 14 cycles.

Baseline patient characteristics associated with treatment duration in multivariate analyses, overall (cohorts 1 and 2) and according to the reason for treatment initiation (i.e., first-line treatment-naïve patients, and those switching due to intolerance in absence of progression) (cohort 1 only).

Treatment adherence according to the percentage of days covered (PDC) while receiving acalabrutinib, overall and by the reason for treatment initiation (i.e., first-line treatment-naïve patients, and those switching due to intolerance in absence of progression) (cohort 1).

The PDC will be based on data available on acalabrutinib treatment in pharmacy records, and defined as the percentage of days a patient has the medication available in a given period of time:

PDC (%)=(No.days covered)/(No.days of interest)×100

TTNT (i.e., the time from the date of first dose of acalabrutinib to the first dose of the next treatment for CLL, or death from any cause [i.e. deaths are not censored]), overall (cohorts 1 and 2) and according to the reason for treatment initiation (i.e., first-line treatment-naïve patients, and those switching due to intolerance in absence of progression) (cohort 1 only).

OS (i.e., the time from the date of first dose of acalabrutinib to death from any cause), overall (cohorts 1 and 2) and according to the reason for treatment initiation (i.e., first-line treatment-naïve patients, and those switching due to intolerance in absence of progression) (cohort 1 only).

Adverse events that lead to acalabrutinib±venetoclax dose changes, temporary interruptions, or permanent discontinuation.

Adverse events that are considered serious (including fatal events) during acalabrutinib±venetoclax treatment, globally and treatment related (when available).

Events of clinical interest (atrial fibrillation, hypertension, bleeding, infections, ventricular arrhythmias, hepatotoxicity, secondary primary malignancies, cytopenia, and pneumonitis) during acalabrutinib treatment, globally and treatment related (when available).

They will be described overall (cohorts 1 and 2) and according to the reason for treatment initiation (i.e., first-line treatment-naïve patients, and those switching due to intolerance in absence of progression) (cohort 1 only).