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Background Although the number of lymphoma survivors has increased, the needs and research priorities of survivors and their caregivers rarely are examined and addressed. Determining the needs and priorities for this population requires an assessment of the attitudes and experiences of patients and caregivers. The authors conducted a qualitative study with lymphoma survivors and their caregivers to determine care needs and research priorities. Methods In the first phase, 2 semistructured focus groups were conducted with 15 lymphoma survivors and their caregivers. In phase 2, a total of 19 individual semistructured telephone interviews were conducted with lymphoma survivors and their caregivers. In both phases, participants discussed cancer experiences and research priorities. All interviews were transcribed. MAXQDA software (version 18.0.8) was used for coding and identifying themes. Results The majority of participants felt disconnected from their clinical care team due to a lack of communication. Focus group participants noted a lack of information regarding diagnoses, treatment, research, and survivorship care. Participants coped with fear through strong social support and fostering relationships with their clinical care teams. Some caregivers felt completely ignored by clinicians. Participants expressed interest in research, but had difficulty finding relevant studies. Several interviewees desired holistic and survivorship-oriented research and more studies regarding quality of life and mental health. Conclusions The results of the current study identified unmet needs in clinical care and patient-oriented research, including needs for a focus on quality of life after treatment, communication between patients and the scientific community, and emotional well-being. Health care professionals can use these data to provide care delivery, supportive services, and research that meets the needs of lymphoma survivors and their caregivers.

In recent years, oncology has seen a rapid increase in the introduction of high-cost innovative therapies while scrutiny around drug pricing has simultaneously amplified. Significant policy shifts impacting health coverage and benefit design are also being implemented, including narrow network health plans, uncertainty around the Affordable Care Act insurance exchanges, and threats to preexisting condition protections. Shifting health coverage policy combined with high drug prices and outdated reimbursement systems may create barriers to patient access to innovation and high-quality cancer care. To understand how trends in health policy are impacting the oncology ecosystem, NCCN convened the NCCN Policy Summit: Policy Strategies for the “New Normal” in Healthcare to Ensure Access to High-Quality Cancer Care on June 25, 2018. The summit included discussion of how innovation is changing cancer treatment, care delivery, and ways health systems are responding; the impact of narrow networks on access to academic cancer centers; and how the evolving health policy landscape is affecting access to high-quality cancer care for patients.

Objective: To evaluate how treatment regimens in informCLL aligned with NCCN Guidelines®-recommended regimens for CLL/SLL. Patients: Patients receiving approved CLL treatment were categorized by del(17p)/TP53 mutation status, line of therapy, and age/comorbidity. Significant comorbidities (SC) were defined as Charlson Comorbidity Index (CCI) ≥3. Age/comorbidity groups for patients without del(17p)/TP53mut: frail (≥65 years)+SC; elderly (≥65) without SC or younger ( Results: In informCLL (N=1462; previously untreated [1L], 58%; relapsed/refractory [R/R], 42%), community-based practices enrolled 93%. Median age: 71 years (34–95); median CCI: 1.0 (0–11); CCI ≥3: 16%. 27% of patients (n=389) had del(17p)/TP53mut data available. 59%–64% with del(17p)/TP53mut and 68%–100% without del(17p)/TP53mut received NCCN-recommended regimens. For patients with del(17p)/TP53mut, 62% 1L and 44% R/R received recommended category-2A ibrutinib; 24% 1L and 21% R/R had non-recommended CIT (BR/FCR). For patients without del(17p)/TP53mut and frail+SC, 60% 1L had category-1 ibrutinib or obinutuzumab+chlorambucil, but 24% received non-recommended BR; all R/R patients had category-1 ibrutinib or idelalisib+rituximab. For patients without del(17p)/TP53mut and elderly/younger+SC, 69% 1L and 58% R/R patients had category-1 ibrutinib or category-2A BR. For patients without del(17p)/TP53mut and younger without SC, 87% 1L and 82% R/R had BR (category-2A), FCR (1L: category-1; R/R: category-2A), or ibrutinib (1L: category-2A; R/R: category-1). For patients without del(17p)/TP53mut data available (73%, n=1073), ibrutinib (44%), CIT (32%), and anti-CD20 monotherapy (14%) were the most common regimens. Conclusions: Of patients with del(17p)/TP53mut, one-third received non-NCCN-recommended regimens. Given most patients in informCLL lacked del(17p)/TP53mut data and may have received suboptimal therapy, there is a need for awareness of guidelines recommendations to better inform treatment decisions. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma V.2.2017 - February 21, 2017. © National Comprehensive Cancer Network, Inc. 2017. All rights reserved. Accessed 08/08/2017. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use, or application and disclaims any responsibility for their application or use in any way.

Background: Treatment options, together with guidelines, for pts with CLL have evolved and expanded with the introduction of novel agents. The informCLLTM registry is the largest US-based prospective, observational registry of pts who received treatment for CLL/SLL in the post-novel agent era. This prospective real-world registry is uniquely positioned to examine the impact of the dynamic treatment landscape, treatment practices, and outcomes in routine clinical setting. Here we present baseline characteristics, prognostic biomarker testing, and treatment patterns for the fully enrolled pt population. Methods: From Oct 2015 to June 2019, informCLL (PCYC-1134; NCT02582879) enrolled eligible pts with CLL/SLL who were ≥18 years (y), initiated FDA-approved treatment for CLL/SLL within ±45 days of enrollment and provided consent. Pts were classified into 5 groups based on treatment received at enrollment (index): ibrutinib (single agent or combination), chemoimmunotherapy (CIT), chemotherapy (CT), immunotherapy (IT), and other novel agents. Descriptive analyses are presented. Results: The registry fully enrolled with 1461 pts: 855 (59%) previously untreated and 606 (41%) relapsed/refractory (R/R) pts. Community-based practices enrolled 93% of pts. The median age was 71 y (33% ≥75 y), the majority were male (64%), and 88% had ECOG performance status of 0/1. For pts with staging performed at enrollment (n=852), 51% had Rai stage III/IV. Median (range) time from diagnosis to initial treatment on study was 18.6 months (mos, FISH testing was performed in 28% (n=415) of pts and was more frequent in previously untreated vs R/R pts (33% vs 21%). TP53 mutation testing was performed in 11% (n=162) of pts (previously untreated: 13%; R/R: 9%). IGHV mutational status testing was performed in 12% (n=171) of pts (previously untreated: 13%; R/R 10%). Of pts with prognostic biomarker testing, 24% (100/415) had del(17p), 27% (43/162) had TP53 mutation, and 71% (121/171) had unmutated IGHV. Prognostic biomarker testing by treatment group is shown in Figure 1. Table 1 shows the distribution of pts receiving different treatments on study. Across lines of therapy, the most common treatment was ibrutinib (46%); the majority (87%) started ibrutinib treatment at the recommended daily dose of 420 mg, and pts continuing ibrutinib therapy largely did not require dose modifications (75%). At 12 or 24 mos, 77% (307/401) and 68% (126/184) of pts continued on ibrutinib treatment, respectively. For pts who completed the most common CIT regimens (bendamustine + rituximab [BR] and fludarabine + cyclophosphamide + rituximab), 80% and 85%, respectively, received Conclusions: The informCLL registry provides an opportunity to prospectively assess CLL treatment patterns in the era of novel agents. The most common index treatment was ibrutinib and the majority of ibrutinib-treated pts remained on therapy at 2 y follow-up; CIT (primarily BR) was also used for one-third of patients. Prognostic biomarker testing rates were poor, especially for TP53 and IGHV mutational status. Data from informCLL also indicate a 'knowledge gap' in terms of prognostic marker testing and selection of therapies for pts with high-risk disease. Data from the now complete pt population and with continued follow up will allow for the ongoing evaluation of real-world treatment decisions and pt care that cannot be addressed by data from randomized clinical trials. Disclosures Mato: Janssen: Consultancy, Research Funding; Adaptive: Consultancy, Research Funding; AbbVie: Consultancy, Research Funding; TG Therapeutics: Consultancy, Other: DSMB, Research Funding; Genentech: Consultancy, Research Funding; BeiGene: Consultancy; Pharmacyclics LLC, an AbbVie Company: Consultancy, Research Funding; AstraZeneca: Consultancy, Research Funding; LOXO: Consultancy, Research Funding. Barrientos:Janssen: Honoraria; Oncternal Therapeutics: Research Funding; Sandoz: Consultancy; Gilead: Consultancy; Genentech: Consultancy; Bayer: Consultancy; AstraZeneca: Consultancy. Sharman:AbbVie: Consultancy, Research Funding; Pfizer: Consultancy, Research Funding; Pharmacyclics: Consultancy, Research Funding; AstraZeneca: Consultancy, Research Funding; Genentech: Consultancy, Research Funding; BeiGene: Research Funding; Bristol Meyers Squibb: Consultancy, Research Funding; Celgene: Consultancy, Research Funding; Roche: Consultancy, Research Funding; Acerta: Consultancy, Research Funding; TG Therapeutics: Consultancy, Research Funding. Brander:BeiGene: Other, Research Funding; MEI Pharma: Other, Research Funding; DTRM: Other, Research Funding; AbbVie: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other, Research Funding; ArQule: Consultancy, Other, Research Funding; Pfizer: Consultancy, Other; Pharmacyclics LLC, an AbbVie Company: Consultancy, Honoraria, Other, Research Funding; AstraZeneca: Consultancy, Honoraria, Other, Research Funding; Ascentage: Other, Research Funding; Teva: Consultancy, Honoraria; Tolero: Research Funding; TG Therapeutics: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other, Research Funding; Verastem: Consultancy, Honoraria, Other, Research Funding; NCCN: Other; Novartis: Consultancy, Other; NCCN: Other; Genentech: Consultancy, Honoraria, Other, Research Funding; Juno/Celgene/BMS: Other, Research Funding; Novartis: Consultancy, Other; Teva: Consultancy, Honoraria; Tolero: Research Funding. Kadish:Bluebird Bio: Current equity holder in publicly-traded company; Blueprint Medicines: Current equity holder in publicly-traded company; Teva Pharmaceutical: Current equity holder in publicly-traded company; Bristol-Myers Squibb: Current equity holder in publicly-traded company; Editas Medicine: Current equity holder in publicly-traded company; Johnson & Johnson: Current equity holder in publicly-traded company; Sarepta Therapeutics: Current equity holder in publicly-traded company; AbbVie: Current equity holder in publicly-traded company; Agios: Current equity holder in publicly-traded company; Celgene: Current equity holder in publicly-traded company, Speakers Bureau; Takeda: Speakers Bureau. Arango-Hisijara:Bristol-Myers Squibb: Current equity holder in publicly-traded company; AbbVie: Current equity holder in publicly-traded company; Pharmacyclics LLC, an AbbVie Company: Current Employment. Upasani:AbbVie: Current equity holder in publicly-traded company; Pharmacyclics LLC, an AbbVie Company: Current Employment; Protagonist Therapeutics: Current Employment. Han:Johnson and Johnson: Current equity holder in publicly-traded company; Janssen: Current Employment, Other: Travel expenses. Huang:Janssen Scientific Affairs, LLC: Current Employment; Johnson & Johnson: Current equity holder in publicly-traded company. Iyengar:Express Scripts: Patents & Royalties; AbbVie: Current equity holder in publicly-traded company; Pharmacyclics LLC, an AbbVie Company: Current Employment. Ghosh:Karyopharm: Consultancy; Genmab: Consultancy, Speakers Bureau; SGN: Consultancy, Research Funding, Speakers Bureau; Pharmacyclics LLC, an AbbVie Company: Consultancy, Research Funding, Speakers Bureau; Kite/Gilead: Consultancy, Speakers Bureau; Juno/Celgene/Bristol-Myers Squibb: Consultancy, Research Funding; Janssen: Consultancy, Research Funding, Speakers Bureau; Forty Seven Inc: Consultancy, Other: Research Bureau, Research Funding; Celgene/Bristol-Myers Squibb: Speakers Bureau; AbbVie: Speakers Bureau; AstraZeneca: Speakers Bureau; TG Therapeutics: Consultancy, Research Funding; Roche/Genentech: Research Funding.

informCLL is the first United States-based registry of patients with chronic lymphocytic leukemia that initiated enrollment after approval of novel targeted agents. Prognostic/predictive testing rates and chronic lymphocytic leukemia treatment selection with availability of novel agents have not been previously investigated in clinical practice. Results from this interim analysis demonstrate that prognostic/predictive testing was infrequently used to guide treatment selection, potentially inhibiting beneficial outcomes for patients. Introduction: The therapeutic landscape for chronic lymphocytic leukemia (CLL) has significantly shifted with the approval of novel agents. Understanding current prognostic testing and treatment practices in this new era is critical. Beginning enrollment in 2015, informCLL is the first United States-based real-world, prospective, observational registry that initiated enrollment after approval of novel agents. Patients and Methods: Eligible patients were age ≥ 18 years, started CLL treatment within 30 days of enrollment, and provided consent. For this planned interim analysis, treatments were classified into 5 groups: ibrutinib, chemoimmunotherapy, chemotherapy, immunotherapy, and other novel agents. Results: Frequency of prognostic testing and treatment patterns are reported among 840 patients (459 previously untreated; 381 relapsed/refractory), enrolled largely (96%) from community practice settings. Testing for chromosomal abnormalities by fluorescence in situ hybridization, TP53 mutation, or IGHV mutation status occurred infrequently among all patients (31%, 11%, and 11%, respectively). Chemoimmunotherapy was the most common treatment in previously untreated patients (42%), whereas ibrutinib was the most common treatment among relapsed/ refractory patients (51%). Of patients who tested positive for del(17p) or TP53 mutation, 34% and 26% received chemoimmunotherapy, respectively. Among patients who did not have fluorescence in situ hybridization or TP53 mutation testing prior to enrollment, 33% and 32% received chemoimmunotherapy, respectively. Conclusion: Our findings indicate that prognostic testing rates were poor, and approximately one-third of high-risk patients (del[17p] and TP53) received chemoimmunotherapy, which is not aligned with current CLL treatment recommendations. This represents an opportunity to educate and alert health care professionals about the necessity of prognostic testing to guide optimal CLL treatment decisions.

Context Understanding clinical characteristics and treatment selection for elderly patients is essential in the era of novel agents. informCLL ( NCT02582879 , September 2015 initiation) is an ongoing, US-based, prospective, real-world observational registry of patients with CLL. Objective To characterize overall demographics of previously untreated elderly CLL patients and compare clinical factors and treatment choice of those aged 65-74 years (Group 1) versus ≥75 years (Group 2). Design/Patients An interim analysis (November 2018 data cut) of previously untreated patients from the informCLL registry who were aged ≥65 years and received single-agent ibrutinib, chemoimmunotherapy, or immunotherapy at enrollment. Association between age groups and treatment choice was assessed by multinomial logistic regression after adjusting for comprehensive demographic and clinical factors. Results Analysis included 449 elderly patients (Group 1: 238; Group 2: 211); median age was 74 years. Most patients were male (64.1%), white (92.4%), treated in community settings (94.9%), and Medicare/Medicaid-insured (88.4%). Median time from initial diagnosis to first treatment was 2.0 years. The majority had an Eastern Cooperative Oncology Group (ECOG) score ≤ 1 (87.1%) and Charlson Comorbidity Index (CCI) score ≤ 1 (62.0%). The most common comorbidities were hypertension (69.3%), other cardiovascular disorders (29.2%), non-CLL malignancies (26.3%), and connective tissue diseases (24.5%). Documented cytogenetic/molecular testing rates were low: TP53, 6.01%; IGHV, 5.35%; CLL FISH, 17.8%; any of the three, 18.7%. 202 (45.0%) patients received ibrutinib, 170 (37.9%) received chemoimmunotherapy, and 77 (17.1%) received immunotherapy. Group 2 (vs Group 1) had poorer performance status (ECOG scores ≥2, 12.9% vs 5.7%, p=0.01), more comorbidities (CCI scores ≥2, 45.5% vs 31.1%, p Conclusions Previously untreated real-world CLL patients aged ≥75 years (vs 65-74 years) had poorer performance status, more comorbidities, lower cytogenetic/molecular testing rates, and a higher likelihood of receiving ibrutinib versus chemoimmunotherapy as initial treatment.

Background : Prior to the approvals of ibrutinib (ibr), idelalisib, and venetoclax, data from the Connect CLL registry showed that across 199 US centers only 65% of patients (pts) had FISH testing and 6% had IGHV testing performed prior to the first chronic lymphocytic leukemia (CLL)-directed treatment (tx), and 40% had repeat FISH testing prior to a subsequent therapy (Mato, Br J Haematol 2016). In today's era, molecular-genetic testing should be universally performed to guide tx decisions for pts with CLL, particularly for pts with 17p deletion (del[17p]), TP53 mutation, and/or unmutated IGHV (U-CLL), as recommended by several guidelines. Whether the widespread availability of novel agents has improved prognostic testing patterns and if those results are appropriately utilized in selecting therapies remain important unanswered questions. InformCLL (NCT02582879) is a US, multicenter, prospective, observational real-world registry of pts with CLL receiving various lines of tx across 150 centers (96% community, 4% academic). This analysis describes rates of prognostic testing in pts with CLL stratified by line of therapy, proportions of pts with specific abnormalities, and current tx patterns in clinical practice in this registry. Methods : Enrollment began in Oct 2015. Eligible pts had to be ≥18 years (y), start approved anti-CLL tx within 30 days of enrollment, and provide consent. First tx at enrollment was classified into 5 groups: chemoimmunotherapy (CIT), chemotherapy (CT), immunotherapy (IT), ibr, and other novel agents. For this interim analysis (data cut: Feb 2018), the number of pts with CLL who had testing performed for FISH, TP53 mutational status, and IGHV mutational status, as well as CLL tx for subgroups of pts stratified by abnormality, was summarized as frequency counts and percentages. Results : At the time of this analysis, the registry had enrolled 840 pts (459 previously untreated; 381 relapsed or refractory [R/R]). The majority of pts were male (64%) and Caucasian (92%); median (range) age was 70y (34-95), and median (range) Charlson Comorbidity Index was 2 (0-9). Overall, prognostic biomarker testing was performed infrequently. Among all pts (N=840), 262 (31%) had FISH testing, 89 (11%) had testing performed for TP53 mutation, and 94 (11%) had testing for IGHV mutational status (Table 1). Among 459 pts tested prior to first-line tx, 164 (36%) had testing for FISH, 54 (12%) for TP53, and 55 (12%) for IGHV; among 381 R/R pts, 98 (26%) had testing for FISH, 35 (9%) for TP53, and 39 (10%) for IGHV. For tested pts, 70/262 (27%) pts had del(17p), 23/89 (26%) had mutated TP53, and 69/94 (73%) had U-CLL. For previously untreated tested pts, 47/164 (29%) had del(17p), 14/54 (26%) had mutated TP53, and 35/55 (64%) had U-CLL; for tested R/R pts, 23/98 (23%) had del(17p), 9/35 (26%) had mutated TP53, and 34/39 (87%) had U-CLL. Among 70 pts with del(17p), the most common tx was ibr (n=38; 54%); however, a considerable proportion of pts received CT/CIT (n=24; 34%) (Table 2). In 47 previously untreated pts with del(17p), 27 (57%) received ibr and 16 (34%) received CT/CIT; in 23 R/R pts with del(17p), 11 (48%) received ibr and 8 (35%) CT/CIT. Among 23 pts with mutated TP53, 15 (65%) were treated with ibr, while 7 (30%) with CT/CIT. Of 14 previously untreated pts with mutated TP53, 9 (64%) received ibr and 5 (36%) CT/CIT; of 9 R/R pts with mutated TP53, 6 (67%) received ibr and 2 (22%) CT/CIT. Among 69 pts with U-CLL, 30 (43%) were treated with ibr and 32 (46%) with CT/CIT. In 35 previously untreated pts with U-CLL, CT/CIT was more common (n=20; 57%) than ibr (n=13; 37%), while in 34 R/R pts with U-CLL, ibr was more common (n=17; 50%) than CT/CIT (n=12; 35%). Conclusions : There remains a considerable lack of prognostic marker testing among pts with CLL in the modern era. These findings, as compared to prior registry results, suggest that the advent of novel agents and specific testing guidelines (eg, iwCLL) have not improved prognostic testing patterns in the real-world setting. Moreover, of pts tested who had abnormalities such as del(17p), TP53 mutation, or U-CLL, approximately one-third still received CIT. These results underscore a need to educate on how to utilize these markers to guide CLL tx decisions for optimal clinical outcomes. Additional evaluations (eg, regression analyses) to identify factors associated with failure to perform FISH, TP53, and IGHV testing are planned. Disclosures Mato: Portola: Research Funding; Celgene: Consultancy; AstraZeneca: Consultancy; AbbVie: Consultancy, Research Funding; Medscape: Honoraria; TG Therapeutics: Consultancy, Research Funding; Prime Oncology: Honoraria; Regeneron: Research Funding; Johnson & Johnson: Consultancy; Acerta: Research Funding; Pharmacyclics, an AbbVie Company: Consultancy, Research Funding. Barrientos:Janssen: Consultancy; Gilead: Consultancy, Research Funding; AbbVie: Consultancy, Research Funding; Pharmacyclics, an AbbVie Company: Consultancy, Research Funding. Brander:BeiGene: Other: Institutional research funding for non investigator initiated clinical trial, Research Funding; Genentech: Consultancy, Honoraria, Other: Institutional research funding for non investigator initiated clinical trial, Research Funding; Novartis: Consultancy, Other: DSMB; DTRM: Other: Institutional research funding for non investigator initiated clinical trial, Research Funding; Pharmacyclics, an AbbVie Company: Consultancy, Honoraria, Research Funding; AbbVie: Consultancy, Honoraria, Other: Institutional research funding for non investigator initiated clinical trial, Research Funding; Teva: Consultancy, Honoraria; TG Therapeutics: Consultancy, Honoraria, Other: Institutional research funding for non investigator initiated clinical trial, Research Funding; Acerta: Other: Institutional research funding for non investigator initiated clinical trial, Research Funding. Pagel:Pharmacyclics, an AbbVie Company: Consultancy; Gilead: Consultancy. Kadish:Pharmacyclics, an AbbVie Company: Speakers Bureau; Celgene: Speakers Bureau; Janssen: Speakers Bureau; Takeda: Speakers Bureau. Ghosh:Celgene: Consultancy; PCYC: Consultancy, Research Funding, Speakers Bureau; Gilead: Consultancy, Speakers Bureau; Pharmacyclics, an Abbvie Company: Consultancy, Research Funding, Speakers Bureau; SGN: Consultancy, Research Funding, Speakers Bureau; Forty seven Inc: Research Funding; TG Therapeutics: Honoraria, Research Funding; F. Hoffman-La Roche Ltd: Research Funding; Genentech: Research Funding; Spectrum: Consultancy; Abbvie: Consultancy, Speakers Bureau; Juno: Consultancy, Research Funding. Giafis:Pharmacyclics, an AbbVie Company: Employment, Other: Travel; AbbVie: Equity Ownership. Ipe:AbbVie: Equity Ownership; Pharmacyclics, an AbbVie Company: Employment, Other: Travel. Upasani:Pharmacyclics, an AbbVie Company (self and immediate family member): Employment; AbbVie (self and immediate family member): Equity Ownership. Sundaram:AbbVie: Employment, Equity Ownership, Other: Travel; Johnson & Johnson: Employment, Equity Ownership, Other: Travel. Ferrante:Janssen: Employment, Equity Ownership. Amaya-Chanaga:AbbVie: Equity Ownership, Other: Research performed while employed as an investigator of this study at UCSD. Review and approval of abstract performed while employed at Pharmacyclics, LLC, an AbbVie Company.; Pharmacyclics, an AbbVie Company: Employment, Other: Research performed while employed as an investigator of this study at UCSD. Review and approval of abstract performed while employed at Pharmacyclics, LLC, an AbbVie Company.. Iyengar:Pharmacyclics, an AbbVie company: Employment; AbbVie: Equity Ownership; Express Scripts: Patents & Royalties. Sharman:Acerta: Consultancy, Research Funding; Pharmacyclics, an AbbVie Company: Consultancy, Research Funding.

Background : Chronic lymphocytic leukemia (CLL) treatment (tx) has changed dramatically with the emergence of novel targeted therapies, and real-world data from observational studies continue to improve our understanding of tx patterns/outcomes. Beginning enrollment Oct 2015, informCLL (NCT02582879) began as a US, multicenter, prospective, observational real-world registry of patients (pts) with CLL who received CLL tx. From registry data, we describe demographic and clinical characteristics of pts with CLL, as well as tx patterns, dosing, and sequencing in clinical practice. Methods : In the informCLL registry, 96% of recruiting sites across the US were community hematology-oncology sites. For this planned interim analysis (data cut: Feb 2018), txs were classified into 5 groups based on first tx at enrollment: chemoimmunotherapy (CIT), chemotherapy (CT), immunotherapy (IT), ibrutinib (ibr), and other novel agents. Eligible pts had to be ≥18 years (y), initiate tx of approved anti-CLL therapy within 30 days of enrollment, and provide consent. Categorical variables were summarized as frequency counts and percentages. Continuous variables were summarized as median, range, mean, and standard deviation. Results : 840 pts (previously untreated, n=459; relapsed or refractory [R/R], n=381) were enrolled. Median age was 70y (previously untreated=69y; R/R=71y). Most pts were male (64%), Caucasian (92%), and presented with ECOG PS 0/1 (previously untreated: 88%; R/R: 86%) (Table 1). 45% of previously untreated and 57% of R/R pts presented with Rai stage III/IV. Hypertension and type 2 diabetes were the most common comorbidities. At enrollment, the 3 most common txs were ibr (44%), CIT (34%), and IT (15%). In previously untreated pts, CIT was the most common tx (overall=42%; bendamustine+rituximab [BR]=20%, fludarabine+cyclophosphamide+rituximab [FCR]=10%, obinutuzumab+chlorambucil [GC]=9%) and single-agent ibr was the most common novel agent (38%). In R/R pts, single-agent ibr was the most common tx (48%). In pts Conclusions : The most common agent used across all lines of tx was ibr. Most ibr-treated pts started at the FDA-recommended once-daily dose of 420 mg, with few dose interruptions/reductions. Most pts who received BR, FCR, or GC did not receive 6C of tx. Of pts who initiated subsequent tx, ibr was commonly used in pts who received IT, CIT, or CT. Few pts who received ibr switched to subsequent therapy. Continued follow up will further inform tx practices and enhance our understanding of CLL tx in the real-world setting. Disclosures Sharman: Pharmacyclics, an AbbVie Company: Consultancy, Research Funding; Acerta: Consultancy, Research Funding. Barrientos:Janssen: Consultancy; Gilead: Consultancy, Research Funding; AbbVie: Consultancy, Research Funding; Pharmacyclics, an AbbVie Company: Consultancy, Research Funding. Brander:Teva: Consultancy, Honoraria; Genentech: Consultancy, Honoraria, Other: Institutional research funding for non investigator initiated clinical trial, Research Funding; DTRM: Other: Institutional research funding for non investigator initiated clinical trial, Research Funding; BeiGene: Other: Institutional research funding for non investigator initiated clinical trial, Research Funding; Acerta: Other: Institutional research funding for non investigator initiated clinical trial, Research Funding; Novartis: Consultancy, Other: DSMB; TG Therapeutics: Consultancy, Honoraria, Other: Institutional research funding for non investigator initiated clinical trial, Research Funding; AbbVie: Consultancy, Honoraria, Other: Institutional research funding for non investigator initiated clinical trial, Research Funding; Pharmacyclics, an AbbVie Company: Consultancy, Honoraria, Research Funding. Pagel:Gilead: Consultancy; Pharmacyclics, an AbbVie Company: Consultancy. Kadish:Janssen: Speakers Bureau; Celgene: Speakers Bureau; Takeda: Speakers Bureau; Pharmacyclics, an AbbVie Company: Speakers Bureau. Ghosh:Celgene: Consultancy; PCYC: Consultancy, Research Funding, Speakers Bureau; Gilead: Consultancy, Speakers Bureau; Abbvie: Consultancy, Speakers Bureau; F. Hoffman-La Roche Ltd: Research Funding; Pharmacyclics, an Abbvie Company: Consultancy, Research Funding, Speakers Bureau; Genentech: Research Funding; TG Therapeutics: Honoraria, Research Funding; Spectrum: Consultancy; Forty seven Inc: Research Funding; SGN: Consultancy, Research Funding, Speakers Bureau; Juno: Consultancy, Research Funding. Giafis:Pharmacyclics, an AbbVie Company: Employment, Other: Travel; AbbVie: Equity Ownership. Ipe:AbbVie: Equity Ownership; Pharmacyclics, an AbbVie Company: Employment, Other: Travel. Upasani:AbbVie (self and immediate family member): Equity Ownership; Pharmacyclics, an AbbVie Company (self and immediate family member): Employment. Sundaram:AbbVie: Employment, Equity Ownership, Other: Travel; Johnson & Johnson: Employment, Equity Ownership, Other: Travel. Ferrante:Janssen: Employment, Equity Ownership. Amaya-Chanaga:AbbVie: Equity Ownership, Other: Research performed while employed as an investigator of this study at UCSD. Review and approval of abstract performed while employed at Pharmacyclics, LLC, an AbbVie Company.; Pharmacyclics, an AbbVie Company: Employment, Other: Research performed while employed as an investigator of this study at UCSD. Review and approval of abstract performed while employed at Pharmacyclics, LLC, an AbbVie Company.. Iyengar:AbbVie: Equity Ownership; Pharmacyclics, an AbbVie company: Employment; Express Scripts: Patents & Royalties. Mato:Pharmacyclics, an AbbVie Company: Consultancy, Research Funding; AstraZeneca: Consultancy; Portola: Research Funding; Johnson & Johnson: Consultancy; Acerta: Research Funding; AbbVie: Consultancy, Research Funding; Prime Oncology: Honoraria; Celgene: Consultancy; Regeneron: Research Funding; Medscape: Honoraria; TG Therapeutics: Consultancy, Research Funding.

Background: Over 15,000 new cases of CLL are diagnosed each year in the U.S. Different treatment options exist, which vary in efficacy, side effects, and mode of administration. Little is known about the value patients place upon the different attributes of available CLL treatments. Objectives: To estimate patient preferences for CLL treatments and investigate the relationship between treatment preferences and cost. Methods: Patients with a self-reported physician diagnosis of CLL were recruited through a patient advocacy group to complete an online discrete-choice experiment (DCE) survey. The survey included 8 DCE questions in which respondents chose between pairs of hypothetical treatments for CLL. Each hypothetical treatment was defined by 5 attributes with several predefined levels; the attributes were progression-free survival (PFS; 10-60 months), diarrhea (none to severe), chance of severe infection (0-30%), chance of organ damage (0-8%), and mode and schedule of administration (pill versus intravenous administration). Treatment duration was not addressed independently and treatment cost was not included in the DCE. Random-parameters logit (RPL) was used to analyze the data and estimate patient preference weights for each attribute level in the survey. An importance score and minimum acceptable benefit score were calculated using results from the RPL model. Later, a cost attribute was added that included 2 hypothetical treatment profiles (Treatment A: 26 months of PFS, no diarrhea, 15% chance of serious infection, 8% chance of organ damage, IV once a month for 6 months, and lower cost; Treatment B: 60 months of PFS, mild/moderate diarrhea, 30% chance of serious infection, no chance of organ damage, daily pill for 60 months, and higher cost). Results from the RPL model were used to predict the share of respondents who would choose each treatment based on the DCE questions when cost was not a consideration, as compared with respondents' choices when cost was included. Results: 384 respondents recruited through LLS: 53% were female, 94% were white, and the mean age was 65 years. 57% had Medicare insurance, 53% of respondents had received financial aid and 40% reported difficulty in paying out-of-pocket costs for their medicines. In the DCE results, the attribute levels were ordered as expected, with respondents preferring better outcomes to worse. Within each attribute, all levels were statistically significantly different from each other (P ≤ 0.05). Attributes in the order of importance to patients as determined by DCE were PFS, chance of infection, chance of organ damage and the occurrence and severity of diarrhea. Mode of administration was the least important attribute. Although PFS had the highest importance score, the risk of adverse events was also highly important to patients; significant additional PFS was needed to offset patients' acceptance of worsening adverse events. For example, an increase in the chance of infection from 0% to 30% required an offset of 36 months of additional PFS. An increase in the chance of organ damage from 0% to 8% required an additional 26 months of PFS by the respondents. A tradeoff of 22 additional months in PFS is needed for a change from no diarrhea to severe diarrhea. Using results from the RPL model, it was predicted that 91% of respondents would choose Treatment B when cost is excluded from the treatment profile description. This was mainly driven by the better PFS attribute of Treatment B. When a modest cost difference was introduced ($75 more per month for treatment B), half of the patients chose treatment A. When this difference became larger ($400 more per month), the change in patient preference was even more pronounced; 74% chose option A. Conclusions: The most important attribute in the survey was PFS, however patients also indicated that increases in the risk of adverse events would require significant increase in PFS to offset that risk. Patients with CLL are sensitive to treatment costs and many reported difficulty in paying for their medications. Given the choice of treatments available to patients and the high cost of some treatments, physicians may want to explore their patients' preferences for different treatment features, including benefit-risk tradeoffs and out-of-pocket cost when selecting the best treatment strategies for patients. Disclosures Mansfield: RTI Health Solutions: Other: Research for this abstract was performed in the course of my employment at Research Triangle Institute d/b/a RTI Health Solutions, pursuant to a contract between my employer and the study sponsor, Genentech. RTI was compensated by the sponsor.. Masaquel:Roche: Equity Ownership; Genentech: Employment. Sutphin:RTI Health Solutions: Other: Research for this abstract was performed in the course of my employment at Research Triangle Institute d/b/a RTI Health Solutions, pursuant to a contract between my employer and the study sponsor, Genentech. RTI was compensated by the sponsor.. Li:Genentech: Employment; Roche: Equity Ownership. Reyes:Genentech: Employment; Roche: Equity Ownership.