Real-world treatment patterns and clinical outcomes of patients with treatment-naïve and relapsed/refractory diffuse large B-cell lymphoma in the United States.

BACKGROUND: With the evolving treatment landscape and growing therapeutic options, it is essential to understand the treatments currently used in real-world clinical practice and the associated outcomes among patients with DLBCL to identify potential unmet treatment needs.

PATIENTS AND METHODS: This retrospective longitudinal cohort study examined treatment patterns and outcomes for diffuse large B-cell lymphoma (DLBCL) patients using the COTA electronic health records database from 2016 to 2023. The study population included 3569 patients, treated in community oncology settings, who received first-line (1L) therapy.

RESULTS: Nineteen percent of patients relapsed after 1L chemoimmunotherapy (primarily R-CHOP). The most common second-line treatments included rituximab-based regimens and autologous stem cell transplant (ASCT). Antibody-drug conjugates (ADCs) and CAR T-cell therapy were administered in third-line or later. Median progression-free survival (PFS) and overall survival (OS) decreased with each line. Relapsed/refractory real-world DLBCL patients experienced poor outcomes (24-month OS of 41.7 %). Patients receiving ASCT or CAR T-cell therapy had better OS than those who did not receive cellular therapies, with 24-month OS of 78 %, 54 %, and 31 %, respectively.

CONCLUSION: This study highlights the need for improved treatment options and increased access to novel therapies, emphasizing gaps in community oncology settings.