Clinical Outcomes of Patients with Relapsed/Refractory Large B-Cell Lymphoma Receiving Second-Line Therapy in England: A Multicenter, Retrospective, Real-World Study
Fox CP1, Toron F2, Tyas E3, Cooper M3, Richards J3, Williams P4
1University of Nottingham, Nottingham, Nottinghamshire, UK, 2Bristol Myers Squibb, LONDON, LON, UK, 3Lumanity, Sheffield, DBY, UK, 4Bristol Myers Squibb, Uxbridge, Buckinghamshire, UK
OBJECTIVES: High-dose chemotherapy and autologous stem-cell transplant (HDT-ASCT) is standard second-line consolidation therapy in relapsed or refractory large B-cell lymphoma (R/R LBCL). However, a large proportion of patients are considered ineligible for this treatment. This study examines the impact of ASCT-eligibility on survival outcomes in R/R LBCL.
METHODS: This retrospective, observational study included patients with R/R LBCL treated at one of six English referral centers. Patients who met inclusion criteria were stratified by ASCT-eligibility. The ASCT-eligible group comprised both those who had received ASCT, and those who were eligible for but did not receive ASCT. Eligibility was assessed based on second-line regimen received, and predefined physiological parameters validated by clinical experts. The Kaplan-Meier method was used to estimate survival probability. Hazard ratios (HRs) were estimated using a univariate Cox proportional hazards model with ASCT-eligible as reference.
RESULTS: In total, 299 patients met eligibility criteria, of whom 223 were ASCT-eligible, 49 ineligible, and 27 unclassified. ASCT-eligible patients were younger than ineligible patients (mean age 56.5 vs. 74.7 years), with lower ECOG scores (60.1% vs. 42.9% with ECOG 0-1). Of the ASCT-eligible group, 98 patients (40.4%) underwent ASCT. Median overall survival was 18.71 months [95% CI: 13.15–33.44] and 6.94 months [95% CI: 4.77–9.11] for ASCT-eligible and ineligible patients respectively, with an HR of 2.39 [95% CI: 1.70–3.37] for death. Median progression-free survival was 6.67 months [95% CI: 4.67–8.71] and 4.27 months [95% CI: 2.40–6.35] respectively, with an HR of 1.54 [95% CI: 1.10–2.15] for progression. Median event-free survival was 6.08 months [95% CI: 3.95–7.99] and 4.27 months [95% CI: 2.40–6.35] respectively, with a HR of 1.46 [95% CI: 1.05–2.04] for an event.
CONCLUSIONS: Over half of ASCT-eligible patients did not receive ASCT. Nevertheless, ASCT-eligible patients have significantly better survival outcomes than ineligible patients, highlighting an unmet need in the ASCT-ineligible population.
Conference/Value in Health Info
Value in Health, Volume 26, Issue 11, S2 (December 2023)
Clinical Outcomes Assessment
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology