Dr David Andorsky on BTK Inhibitor Treatment Patterns and SDOH in CLL, SLL

David J. Andorsky, MD, board-certified medical oncologist and hematologist at Rocky Mountain Cancer Centers, a practice in the US Oncology Network, discussed findings from a study on patterns of care and social determinants of health (SDOH) among patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). The research was presented at the 2023 American Society of Hematology Annual Meeting.

Transcript

Your study found that rural settings were associated with different treatment patterns for CLL/SLL. Can you briefly discuss those trends and their implications?

What we observed was that the patients in a rural environment were actually a little more likely to receive one of the newer medications, either acalabrutinib or zanubritunib. It was not a huge effect size, and the number of patients in a rural environment were small in the study, so I would take those findings with sort of a note of caution or that it's more hypothesis-generating as opposed to definitive. It was reassuring, though, because I think one might have expected that you would see patients not getting those new medications in what's traditionally thought of as a kind of medically underserved environment. It's nice to see that those patients, in our network at least, have access to the latest medications.

As novel therapies are tested in clinical trials and approved, what can be done to try and close treatment gaps fueled by SDOH?

Understanding what patients' barriers are to receiving treatment. Is it a financial barrier? Is it that they don't have a ride to get to their office visits? That can be a big burden for people—I think less so with the oral medications because you don't have to come to clinic every week, but that still can be a barrier. Also, just medical literacy, patients not understanding why they need to take a treatment [or whether it is] really necessary. Those are all things that I think we can all keep working to address.

This transcript has been lightly edited for clarity.