Presentation (CTI)

OBJECTIVES: Prescriber choice architecture is a distillation of comparative effectiveness, trial efficacy, and safety outcomes. We aimed to understand this concept in the rapidly evolving landscape of relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL) centered on treatment selection after CAR T-cell therapy failure, unmet needs for patients with R/R DLBCL, and the ELM-1 study results for the investigative bispecific antibody (BsAb) odronextamab.
METHODS: Survey questions on treatment selection after CAR T-cell therapy failure and ELM-1 results were administered to 66 US-based hematologists/oncologists at an in-person forum in February 2025. Responses were captured via audience response system, and physicians were not required to answer every question. Responses were aggregated and summarized descriptively.
RESULTS: Most participating physicians practiced in community settings (81.8%), with a median 15.5 years in practice. Some (43.3%) currently administered BsAbs in their practice. The most commonly identified unmet treatment need for patients with R/R DLBCL was the lack of effective options for patients refractory to CAR T-cell therapy (59.6%). Prior to reviewing the ELM-1 study, respondents preferred a BsAb (32.3% epcoritamab; 27.7% glofitamab) or loncastuximab (33.8%) as third-line (3L) treatment for a hypothetical transplant-ineligible patient with R/R DLBCL after 2L CAR T-cell therapy failure. After reviewing the ELM-1 study, 56.9% chose odronextamab as 3L treatment for that same hypothetical patient. Top barriers to prescribing odronextamab were the current availability of other anti-CD20 BsAbs (36.9%) and logistical challenges (23.1%). For odronextamab, respondents were interested in additional data on long-term survival outcomes (61.5%) and head-to-head comparisons in effectiveness to other BsAbs (53.8%).
CONCLUSIONS: Physicians were receptive to prescribing the BsAb odronextamab, if approved, for patients with R/R DLBCL after failure of CAR T-cell therapy. Nevertheless, concerns about long-term outcomes and logistical hurdles remain, and comparative studies would further understanding of odronextamab’s performance relative to other BsAbs approved in this space.