REAL-WORLD OUTCOMES OF SECOND-LINE THERAPIES IN RELAPSED/REFRACTORY DLBCL PATIENTS IN GERMANY: IMPACT OF FRONT-LINE TREATMENT-FREE PERIOD (2020-2022)
Author(s)
Guillaume Azarias, PhD1, Kai Strobel, BSc, MSc2, Mugdha Gokhale, PhD3, Simon Purcell, PhD4, Stefan Schilling, MASc2, Markus Rückert, PhD2, Zuzana Dostalova, MSc5.
1CancerDataNet GmbH, Basel, Switzerland, 2TriNetX Oncology GmbH, Freiburg, Germany, 3Pfizer, Collegeville, PA, USA, 4Pfizer, London, United Kingdom, 5TriNetX, LLC, Cambridge, MA, USA.
1CancerDataNet GmbH, Basel, Switzerland, 2TriNetX Oncology GmbH, Freiburg, Germany, 3Pfizer, Collegeville, PA, USA, 4Pfizer, London, United Kingdom, 5TriNetX, LLC, Cambridge, MA, USA.
OBJECTIVES: While many diffuse large B-cell lymphoma (DLBCL) patients are cured by frontline therapy, relapsed or refractory (r/r) cases require further treatments, such as chemotherapy, stem cell transplantation (SCT), and CAR-T therapy. This study analysed r/r DLBCL patients in a real-world setting and assessed how the treatment-free period after frontline therapy (TFP1) influenced survival, distinguishing early (TFP1<12 months) from late relapse (TFP1≥12 months).
METHODS: Real-world data from non-Hodgkin lymphoma treatment centers in Germany included 289 patients who received ≥2L+ therapies in 2022. Retrospective data were collected via certified electronic case report forms, extending back to initial diagnosis.
RESULTS: 2L+ DLBCL patients were predominantly men (65%), with a median age of 72 years and an ECOG score ≥2 (27%). Comorbidities were common, including hypertension (44%), diabetes (20%), and coronary disease (18%). Main symptoms included performance loss, fatigue, and lymphadenopathy. 3L+ patients resemble 2L+ patients in comorbidities and symptoms but had worse ECOG and more extranodal sites.39.4% of patients had an early relapse, of which 20% had TFP1<2 months (primary refractory) and 80% between 2-12 months. The remaining patients had a late relapse. Early relapse patients were significantly younger (age<75), more frequently exhibited symptoms, and were more often diagnosed with Ann Arbor Stage IV disease (p<0.01). They tended to have BCL6 translocations (p<0.1). 2L+ patients with late relapse after SCT had a longer 2L time to next treatment (29.6 months) compared to early relapse patients (17.0 months). The late relapse group experienced fewer deaths, compared to the early relapse patients who demonstrated a shorter overall survival (log-rank p<0.0001).
CONCLUSIONS: Our results highlight the unmet need in r/r DLBCL patients, showing that those with early relapse after 1L are sicker at baseline and have worse overall survival than late relapse patients. These findings support their inclusion in clinical trials for novel treatments.
METHODS: Real-world data from non-Hodgkin lymphoma treatment centers in Germany included 289 patients who received ≥2L+ therapies in 2022. Retrospective data were collected via certified electronic case report forms, extending back to initial diagnosis.
RESULTS: 2L+ DLBCL patients were predominantly men (65%), with a median age of 72 years and an ECOG score ≥2 (27%). Comorbidities were common, including hypertension (44%), diabetes (20%), and coronary disease (18%). Main symptoms included performance loss, fatigue, and lymphadenopathy. 3L+ patients resemble 2L+ patients in comorbidities and symptoms but had worse ECOG and more extranodal sites.39.4% of patients had an early relapse, of which 20% had TFP1<2 months (primary refractory) and 80% between 2-12 months. The remaining patients had a late relapse. Early relapse patients were significantly younger (age<75), more frequently exhibited symptoms, and were more often diagnosed with Ann Arbor Stage IV disease (p<0.01). They tended to have BCL6 translocations (p<0.1). 2L+ patients with late relapse after SCT had a longer 2L time to next treatment (29.6 months) compared to early relapse patients (17.0 months). The late relapse group experienced fewer deaths, compared to the early relapse patients who demonstrated a shorter overall survival (log-rank p<0.0001).
CONCLUSIONS: Our results highlight the unmet need in r/r DLBCL patients, showing that those with early relapse after 1L are sicker at baseline and have worse overall survival than late relapse patients. These findings support their inclusion in clinical trials for novel treatments.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO180
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment, Comparative Effectiveness or Efficacy, Performance-based Outcomes
Disease
SDC: Oncology, STA: Personalized & Precision Medicine