Real‐world patient characteristics, treatment patterns, and treatment outcomes of patients with diffuse large B‐cell lymphoma by line of therapy

Abstract Background Although initial treatment of diffuse large B‐cell lymphoma (DLBCL) with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R‐CHOP) can be effective, up to 50% of patients will develop refractory or relapsed (R/R) disease. This study aimed to provide contemporary data on characteristics, treatment patterns, and outcomes for R/R‐DLBCL. Methods Patients with incident (January 2016 to March 2021) DLBCL age ≥18 years who initiated first‐line (1L) therapy were identified from the COTA real‐world database. Baseline characteristics, treatment patterns, and real‐world outcomes, including time to next treatment (rwTTNT) and overall survival (rwOS), were assessed for the study population and by line of therapy (LOT). Results A total of 1347 eligible DLBCL patients were identified. Of these, 340 (25.2%) proceeded to receive 2L, of whom 141 (41.5%) proceeded to receive 3L, of whom 51 (36.2%) proceeded to receive 4L+. Most common treatments were 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 were more variable in later LOTs. One‐ and 3‐year rwOS from 1L initiation were 88.5% and 78.4%, respectively. Patients who received later LOTs experienced numerically lower 1‐ and 3‐year rwOS (from 2L initiation: 62.4% and 46.4%, respectively). Conclusions In this real‐world analysis, 25.2% of patients experienced R/R‐DLBCL after 1L with poor outcomes. Given the findings of this study, there is a high unmet need for novel, safe, and effective treatment options for patients with R/R DLBCL.