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Addressing R/R DLBCL Therapy in Older Patients

April, 04, 2024 | DLBCL (Diffuse Large B Cell Lymphoma), Lymphoma

KEY TAKEAWAYS

  • The study aimed to offer up-to-date insights on features, treatment trends, and results in R/R-DLBCL patients.
  • The real-world analysis revealed a significant portion experienced R/R-DLBCL after 1L, emphasizing the demand for innovative treatments.

While rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) may initially treat diffuse large B-cell lymphoma (DLBCL) effectively, half may experience refractory or relapsed (R/R) disease.

Helmneh M Sineshaw and the team aimed to present current data on the features, therapeutic approaches, and results for R/R-DLBCL.

Patients aged 18 years and older with incident DLBCL from January 2016 to March 2021, initiating first-line therapy, were identified from the COTA real-world database. Baseline attributes, treatment trends, and real-world results, such as time to next treatment (rwTTNT) and overall survival (rwOS), were evaluated for both the overall study cohort and stratified by line of therapy (LOT).

Of 1347 eligible DLBCL patients, 340 (25.2%) progressed to 2L, with 141 (41.5%) advancing to 3L and 51 (36.2%) proceeding to 4L or beyond. The most common treatments included R-CHOP in 1L (63.6%), stem cell transplant (SCT) in 2L (17.9%), polatuzumab vedotin, bendamustine, and rituximab (Pola-BR) in 3L (9.9%), and chimeric antigen receptor T-cell therapy (CAR-T) in 4L (11.8%).

Treatment patterns showed greater variability in subsequent LOTs. One- and 3-year rwOS rates from 1L initiation were 88.5% and 78.4%, respectively. Patients undergoing later LOTs demonstrated slightly lower 1- and 3-year rwOS rates (from 2L initiation: 62.4% and 46.4%, respectively).

Based on this real-world analysis, a quarter of patients encountered R/R-DLBCL post-initial treatment, leading to unfavorable results. Consequently, there is a significant demand for innovative, secure, and efficient therapies for R/R DLBCL patients.

The study was funded by the Merck Sharp & Dohme LLC.

Source: https://pubmed.ncbi.nlm.nih.gov/38597118/

Sineshaw HM, Zettler CM, Prescott J, et al. (2024) “Real-world patient characteristics, treatment patterns, and treatment outcomes of patients with diffuse large B-cell lymphoma by line of therapy.” Cancer Med. 2024 Apr;13(7):e7173. doi: 10.1002/cam4.7173. PMID: 38597118; PMCID: PMC11004909.

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