Dr. Bond on Second Cancers Following CLL Treatment

David A. Bond, MD, assistant professor, The Ohio State University, discusses the high rates of second cancers in both treatment-naïve and pretreated patients with chronic lymphocytic leukemia (CLL) who received BTK inhibitors.

Prior data suggest that patients with CLL, both treated and untreated, are at an increased risk for second cancers. However, some prior therapies are immunosuppressive and posed a risk of acute myeloid leukemia, according to Bond. With oral agents such as the BTK inhibitors, physicians were interested in seeing whether the incidence of second cancer remains elevated and how much it contributes to morbidity in this patient population.

The study identified 691 patients with CLL, both previously treated and untreated, who were then treated with the BTK inhibitors acalabrutinib (Calquence) or ibrutinib (Imbruvica). The second primary malignancies were catalogued. Non-melanoma skin cancers were separated, as melanoma skin cancers are not included in cancer registries and are generally more localized compared with other invasive second cancers, according to Bond. Results showed that second cancers were the second leading cause of death in this cohort of patients. Compared with the general population, the rates of second cancers remain significantly elevated in patients receiving this class of agents.