A Study to Evaluate Ibrutinib Retention in Chronic Lymphocytic Leukemia Participants Treated in a Real World Setting

Study Overview
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Brief Summary
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The purpose of this study is to describe the 2-year retention rate of ibrutinib treatment for chronic lymphocytic leukemia (CLL) in Italian routine clinical practice.

Official Title
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EValuate Ibrutinib Retention iN Chronic Lymphocytic Leukemia Patients Treated in a rEal World Setting - EVIdeNCE

Conditions
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Leukemia, Lymphocytic, Chronic, B-Cell

Intervention / Treatment
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* Drug: Ibrutinib


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Must have a confirmed diagnosis of Chronic Lymphocytic Leukemia (CLL) requiring treatment (iwCLL [International Workshop on Chronic Lymphocytic Leukemia] criteria) If alive, must sign an Informed Consent Form (ICF) allowing data collection and source data verification in accordance with Italian requirements Participants with one of the following characteristics: a) Participants starting ibrutinib treatment according to the summary of product characteristics (SmPC) at enrolment or within 30 days starting from informed consent signature, as per routine clinical practice and independently of this non-interventional study; OR b) Participants who have started ibrutinib within 3 months before enrollment, according to the SmPC, as per routine clinical practice and independently of this non- interventional study (including also participants who, by the time of enrollment, are not receiving ibrutinib) If alive, must be able to read and write in Italian and to understand and sign the ICF Exclusion Criteria: Currently enrolled in any interventional clinical trial Currently enrolled in observational studies sponsored or managed by Janssen company Treated with any investigational compound or any invasive investigational medical device within 30 days before start of ibrutinib treatment Having contraindications to ibrutinib use as described in the SmPC Pregnant or breast-feeding

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group: Ibrutinib Treatment<br>Participants will not receive any intervention as a part of this study. This study will collect retrospective and prospective real-world data to describe retention rates for participants of chronic lymphocytic leukemia (CLL) receiving ibrutinib in routine Italian clinical practice over a 2-year follow-up period. Participants with CLL who have started ibrutinib treatment within 3 months before enrollment visit or in case ibrutinib was prescribed before or on the enrollment day as per routine clinical practice within the 30 days after enrollment visit will be included in the study. The primary data source for this observational study will be the medical records of each enrolled participant, as well as questionnaires concerning quality of life and treatment adherence. Data will be collected every 3 months for the first year and every 6 months for the second year during prospective period. | Drug: Ibrutinib<br>* Participants in this observational study with confirmed diagnosis of CLL receiving ibrutinib in routine clinical practice settings will be observed approximately for 3 years.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Retention Rate of Ibrutinib | The retention rate is defined as the ratio of the number of participants taking ibrutinib over the number of participants at risk. The retention rate of ibrutinib treatment for (Chronic lymphocytic leukemia) CLL in Italian routine clinical practice will be measured. | Approximately up to 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants Requiring Dose Modifications | Number of CLL participants with at least one ibrutinib treatment dose modification (that is, increase/decrease) will be reported. | Approximately up to 2 years | 
| Overall Response Rate (ORR) | The ORR will be calculated as the proportion of participants who achieve either complete response (CR), partial response (PR) or partial response with lymphocytosis, as assessed by the participating physician. The ORR in CLL participants as per International Workshop on Chronic Lymphocytic Leukemia (iwCLL) criteria is defined as normal circulating lymphocyte count during CR and decrease by greater than or equal to (>=) 50 percent (%) during PR. | Approximately up to 2 years | 
| Time to Best Response | Time to best response is defined as the time from start of ibrutinib therapy until best objective response. Best response will be evaluated based on the following generally accepted algorithm: complete response greater than (>) partial response > partial response with lymphocytosis > stable disease > progressive disease. | Approximately up to 2 years | 
| Time to Treatment Discontinuation(TTD) | Time to treatment discontinuation (TTD) will be calculated as the difference between ibrutinib initiation date and ibrutinib permanent discontinuation date. | Approximately up to 2 years | 
| Time to Next Therapy (TTNT) | The TTNT will be calculated as the difference between ibrutinib initiation date and initiation date of the first next therapy for CLL. | Approximately up to 2 years | 
| Progression Free Survival (PFS) | PFS is defined as the duration from date of ibrutinib initiation to date of disease progression (PD [according to the physician's evaluation]) or death from any cause. PD is defined as >= 50% increase in circulating lymphocyte count as per iwCLL criteria. | From the date of assignment until the date of first documented progression or date of death from any cause, whichever comes first, assessed up to 2 years | 
| Overall Survival (OS) | The OS in CLL participants will be measured and reported from start of ibrutinib therapy to the date of death (all-cause mortality); and from diagnosis to the date of death. | From the date of assignment until the date of death from any cause, whichever comes first, assessed up to 2 years | 
| Number of Participants with Clinically Significant Change in Hematologic Parameters | Number of participants with change in hematologic parameters (complete blood count, hemoglobin, leukocyte count, lymphocyte count, neutrophil count, platelet count) will be determined. | Approximately up to 2 years | 
| Number of Participants with Clinically Significant Change in Biochemistry Parameters | Number of participants with clinically significant change in biochemistry parameters (including lactate dehydrogenase [LDH] and creatinine clearance) will be determined. | Approximately up to 2 years | 
| Change from Baseline in Immunoglobulin levels | Changes in the immunoglobulin levels from baseline will be reported. | Baseline up to 2 years | 
| Number of Participants with at least one Clinical Significant Characteristics | Number of participants with at least one of the following conditions: lymphadenopathy, hepatosplenomegaly, bone marrow involvement, or B-symptoms as provided will be reported. | Approximately 2 years | 
| Number of Participants with Each Grade of Eastern Cooperative Oncology Group (ECOG) Performance Status Score | ECOG performance status is a standard criterion for measuring how the disease impacts daily living abilities. It describes the level of functioning in terms of the ability to care for oneself, daily activity, and physical ability (walking, working, etc). ECOG performance status score ranges from Grade 0 to 5: 0) Fully active and performances without restriction, 1) Restricted in physically strenuous activity, 2) Ambulatory and capable of all self-care but unable to carry out any work activities, 3) Capable of only limited self-care and confined to bed or chair more than 50% of waking hours, 4) Completely disabled, and 5) Dead. | Approximately up to 2 years | 
| Percentage of Participants with Adverse Events (AEs), Serious Adverse Events (SAEs) and Special Situations | An AE is any untoward medical event that occurs in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product. An SAE is any AE that results in: death, persistent or significant disability/incapacity, requires inpatient hospitalization or prolongation of existing hospitalization, is life-threatening experience, is a congenital anomaly/birth defect and may jeopardize participant and/or may require medical or surgical intervention to prevent one of the outcomes listed above. Percentage of participants with AEs, all serious AEs, and all special situations (for example, medication error, overdosing, abuse, lack of effect, unexpected benefits following exposure to ibrutinib) will be reported. | Approximately up to 2 years | 
| Health-Related Quality of Life as Measured by European Quality of Life-5 Dimensions; 5 Levels Questionnaire (EQ-5D-5L) | The EQ-5D questionnaire is a brief, generic health-related quality of life assessment (HRQOL) that can also be used to incorporate participant preferences into health economic evaluations. The EQ-5D-5L descriptive system comprises the following 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression and as overall health using a thermometer visual analog scale with response options ranging from 0 (worst imaginable health) to 100 (best imaginable health). | Approximately up to 2 years | 
| Health-Related Quality of Life as Measured by European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30) Scores | EORTC QLQ-30 designed to measure cancer patients' physical, psychological and social functions. It is composed of multi-item scales (physical, role, social, emotional and cognitive functioning) and single items (pain, fatigue, financial impact, appetite loss, nausea/vomiting, diarrhea, constipation, sleep disturbance and quality of life); high scores on the global and functional scales but low scores on the symptom scales indicate good QOL. QLQ-C30 has four-point scales for the first five items. These are coded with the same response categories as items 6 to 28, namely Not at all, A little, Quite a bit and Very much. For items 29 and 30, a seven-point scale (ranging from 1 = Very Poor to 7 = Excellent) rates overall health and overall quality of life. | Approximately up to 2 years | 
| Medical Resource Utilization | Number of medical care encounters and treatments (including physician or emergency room visits, tests and procedures, and medications, surgeries and other procedures [such as computerized tomography {CT}, x-ray]) will be reported. | Approximately up to 2 years | 
| Duration of Hospitalization | Duration of hospitalization is defined as number of days from the day of admission to discharge (total days length of stay), including duration by wards (for example, intensive care unit). | Approximately up to 2 years | 
| Duration of Medical Care Encounters | Duration of medical care encounters, including surgeries, and other selected procedures (inpatient and outpatient) will be reported. | Approximately up to 2 years | 
| Number of Participants Requiring Blood and Platelets Transfusions | Number of participants requiring blood and platelets transfusions will be reported. | Approximately up to 2 years | 
| Number of Participants Requiring Erythropoietin and Growth Factor Administrations | Number of participants requiring erythropoietin and growth factor administrations will be reported. | Approximately up to 2 years |