{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T10:46:29Z","timestamp":1792406789107,"version":"4.4.0"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hematological Oncology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Multiple targeted agents are available for first\u2010line treatment of chronic lymphocytic leukemia (CLL), yet the absence of mature head\u2010to\u2010head comparisons makes treatment selection challenging. The prospective, multicenter FIRST\u2010CLL study evaluated real\u2010world treatment allocation, and the contribution of biological, clinical, logistical and patient\u2010related factors to first\u2010line regimen choice in Italy. 285 consecutive patients with CLL\/small lymphocytic lymphoma initiating first\u2010line therapy across 13 Centers were included. Treating physicians rated predefined variables guiding treatment selection using the 5\u2010point\n                    <jats:italic>relevance score<\/jats:italic>\n                    . Overall, 116 patients (41%) received continuous Bruton tyrosine kinase inhibitors (BTKi), 114 (40%) ibrutinib plus venetoclax (IV), and 55 (19%) venetoclax plus obinutuzumab (VO). Continuous BTKi were more frequently prescribed in older and comorbid patients, whereas IV was preferentially used in younger individuals.\n                    <jats:italic>TP53<\/jats:italic>\n                    disruption was associated with BTKi use, while mutated immunoglobulin heavy chain status was common in patients receiving VO. According to\n                    <jats:italic>relevance scores<\/jats:italic>\n                    , age, treatment duration and administration route, and patient preference were the most influential determinants of treatment selection. Comorbidity burden additionally guided BTKi prescription, whereas molecular features were more relevant in the selection of fixed\u2010duration regimens. This study offers a real\u2010world quantitative assessment of treatment decision drivers in frontline CLL, offering a data\u2010driven framework to interpret clinical decision\u2010making.\n                  <\/jats:p>","DOI":"10.1002\/hon.70246","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:07:59Z","timestamp":1789560479000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010World Determinants of Treatment Selection in Frontline Chronic Lymphocytic Leukemia: The FIRST\u2010CLL Study"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7538-9626","authenticated-orcid":false,"given":"Francesca","family":"Perutelli","sequence":"first","affiliation":[{"name":"Department of Molecular Biotechnology and Health Sciences University of Torino &amp; University Division of Hematology A.O.U. Citt\u00e0 della Salute e della Scienza di Torino  Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Arata","sequence":"additional","affiliation":[{"name":"Department of Molecular Biotechnology and Health Sciences University of Torino &amp; University Division of Hematology A.O.U. Citt\u00e0 della Salute e della Scienza di Torino  Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaella","family":"Pasquale","sequence":"additional","affiliation":[{"name":"SOC Clinica Ematologica\u2014Centro Trapianti e Terapie Cellulari Azienda Sanitaria Universitaria Friuli Centrale (ASUFC)  Udine Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9719-9284","authenticated-orcid":false,"given":"Sara","family":"Pepe","sequence":"additional","affiliation":[{"name":"Hematology Department of Translational and Precision Medicine Sapienza University of Roma  Roma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maura","family":"Nicolosi","sequence":"additional","affiliation":[{"name":"Division of Hematology A.O.U. Citt\u00e0 della Salute e della Scienza di Torino  Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Deodato","sequence":"additional","affiliation":[{"name":"Department of Haematology Niguarda Cancer Center ASST Grande Ospedale Metropolitano Niguarda  Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Piras","sequence":"additional","affiliation":[{"name":"Hematology and Stem Cell Transplantation Unit Ospedale Oncologico A.\u00a0Businco ARNAS G.\u00a0Brotzu  Cagliari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Fioribello","sequence":"additional","affiliation":[{"name":"S.S.D. Microcitemia, anemie congenite e dismetabolismo del ferro E.O. Ospedali Galliera &amp; Clinic of Hematology Department of Internal Medicine and Medical Specialties University of Genova  Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Bosi","sequence":"additional","affiliation":[{"name":"Division of Hematology Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico  Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7393-1138","authenticated-orcid":false,"given":"Riccardo","family":"Moia","sequence":"additional","affiliation":[{"name":"Division of Hematology Department of Translational Medicine University of Eastern Piedmont  Novara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Ferrario","sequence":"additional","affiliation":[{"name":"UOC Ematologia Azienda Socio Sanitaria Territoriale dei Sette Laghi Ospedale di Circolo di Varese  Varese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michela","family":"Schirru","sequence":"additional","affiliation":[{"name":"Struttura Complessa di Ematologia Ospedale San Francesco ASL Nuoro  Nuoro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5202-2621","authenticated-orcid":false,"given":"Elia","family":"Boccellato","sequence":"additional","affiliation":[{"name":"Division of Hematology Azienda Santa Croce e Carle  Cuneo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8869-3190","authenticated-orcid":false,"given":"Martina","family":"Bullo","sequence":"additional","affiliation":[{"name":"Division of Hematology Mauriziano Hospital  Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Gottardi","sequence":"additional","affiliation":[{"name":"Division of Hematology Mauriziano Hospital  Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myriam","family":"Foglietta","sequence":"additional","affiliation":[{"name":"Division of Hematology Azienda Santa Croce e Carle  Cuneo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9122-4258","authenticated-orcid":false,"given":"Andrea","family":"Galitzia","sequence":"additional","affiliation":[{"name":"Struttura Complessa di Ematologia Ospedale San Francesco ASL Nuoro  Nuoro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2123-7675","authenticated-orcid":false,"given":"Marta","family":"Coscia","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery University of Insubria &amp; UOC Ematologia Azienda Socio Sanitaria Territoriale dei Sette Laghi Ospedale di Circolo di Varese  Varese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4681-0151","authenticated-orcid":false,"given":"Gianluca","family":"Gaidano","sequence":"additional","affiliation":[{"name":"Division of Hematology Department of Translational Medicine University of Eastern Piedmont  Novara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0905-5927","authenticated-orcid":false,"given":"Michele","family":"Merli","sequence":"additional","affiliation":[{"name":"Division of Hematology Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico  Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Salvetti","sequence":"additional","affiliation":[{"name":"Clinic of Hematology IRCCS Ospedale Policlinico San Martino  Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9792-9542","authenticated-orcid":false,"given":"Roberta","family":"Murru","sequence":"additional","affiliation":[{"name":"Hematology and Stem Cell Transplantation Unit Ospedale Oncologico A.\u00a0Businco ARNAS G.\u00a0Brotzu  Cagliari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2587-7901","authenticated-orcid":false,"given":"Anna Maria","family":"Frustaci","sequence":"additional","affiliation":[{"name":"Department of Haematology Niguarda Cancer Center ASST Grande Ospedale Metropolitano Niguarda  Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Freilone","sequence":"additional","affiliation":[{"name":"Division of Hematology A.O.U. 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J.Novak P.Ghia et\u00a0al. \u201cFactors Influencing Physician\u2019s Choice of Fixed\u2010Duration Ibrutinib+Venetoclax or Continuous Ibrutinib Monotherapy in the Treatment of Patients With Previously Untreated CLL: Physician Questionnaire Results From the Prospective Phase 2 TAILOR Study \u201d IwCLL XXI Biennial meeting 2025P1409(2025)."},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.70137"}],"container-title":["Hematological 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