Contributions
Abstract: EP539
Type: E-Poster Presentation
Session title: Aggressive Non-Hodgkin lymphoma - Clinical
Background
Large B-cell lymphomas (LBCLs), including diffuse LBCL (DLBCL), primary mediastinal B-cell lymphoma (PMBCL), and transformed follicular lymphoma (tFL), are treated with combination chemoimmunotherapy at diagnosis. First-line treatment can result in a cure in approximately 60% of cases; however, 10%–15% of patients do not respond and a further 20%–25% relapse. For those patients with chemotherapy-sensitive disease who relapse, autologous hematopoietic stem cell transplantation (auto-HSCT) is an option. For patients who are ineligible for or relapse post–auto-HSCT, the prognosis is poor. Less than 50% of patients respond to subsequent third-line (3L) treatment and few are cured. Median overall survival (OS) with 3L conventional chemotherapy treatment is 4–10 months. Few publications report outcomes of patients treated with 3L conventional chemotherapy in the UK.
Aims
To describe real-world clinical outcomes of patients with relapsed or refractory (R/R) LBCL initiating conventional 3L treatment in the UK.
Methods
This multicenter retrospective analysis was conducted across 6 centers in the UK. Eligible patients were ≥18 years of age with a documented diagnosis of LBCL in 2003 or later. Diagnoses included DLBCL not otherwise specified (NOS; de novo or tFL), high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements with DLBCL histology, follicular lymphoma grade 3B, or PMBCL. Patients had to have received 2 prior lines of systemic treatment, which included an anthracycline and anti-CD20–targeting monoclonal antibody (mAb). Patients with primary central nervous system lymphoma or who had received chimeric antigen receptor (CAR) T cell therapy were excluded. Progression-free survival (PFS) was calculated based on available information for response assessments, receipt of subsequent treatment, and death. PFS and OS were summarized from the start of 3L therapy to progression or death using the Kaplan-Meier method.
Results
A total of 129 patients met the stringent eligibility criteria. The median age of patients was 58 years (range, 22–87 years), 64% were male (n=82), 76% had a disease histology of DLBCL NOS (n=98), 76% had an Eastern Cooperative Group performance status of 0–2 (n=98), and 44 of the 66 patients (67%) who had an International Prognostic Index score had a score of 0–2. The median time from diagnosis to start of 3L treatment was 14.6 months (range, 4–161 months). All patients had received rituximab, 11% received prior auto-HSCT (n=14), and 57% were chemotherapy refractory (n=73). The most common 3L treatment regimens were salvage chemotherapy without an anti-CD20 mAb (44%, n=57), salvage chemotherapy with an anti-CD20 mAb (22%, n=28), salvage chemotherapy followed by auto-HSCT (10%, n=13) or allogeneic HSCT (8%, n=10), pixantrone (4%, n=5), and lenalidomide (4%, n=5), respectively. Clinical and/or imaging assessment data related to 3L treatment was available for 104 patients. The overall response rate was 38% (n=40). Median PFS from the start of 3L treatment was 1.97 months (95% CI, 1.68–2.56 months). Median OS from the start of 3L treatment was 7.00 months (95% CI, 4.73–9.23 months). Additional analyses for patient subgroups will be presented.
Conclusion
This UK real-world analysis provides insights into clinical practice and highlights the poor outcomes achieved with conventional (non–CAR T cell) 3L treatment options in the UK, demonstrating the need for more effective treatments in patients with R/R LBCLs.
Keyword(s): Cellular therapy, Lymphoma therapy, Relapsed lymphoma, Survival
Abstract: EP539
Type: E-Poster Presentation
Session title: Aggressive Non-Hodgkin lymphoma - Clinical
Background
Large B-cell lymphomas (LBCLs), including diffuse LBCL (DLBCL), primary mediastinal B-cell lymphoma (PMBCL), and transformed follicular lymphoma (tFL), are treated with combination chemoimmunotherapy at diagnosis. First-line treatment can result in a cure in approximately 60% of cases; however, 10%–15% of patients do not respond and a further 20%–25% relapse. For those patients with chemotherapy-sensitive disease who relapse, autologous hematopoietic stem cell transplantation (auto-HSCT) is an option. For patients who are ineligible for or relapse post–auto-HSCT, the prognosis is poor. Less than 50% of patients respond to subsequent third-line (3L) treatment and few are cured. Median overall survival (OS) with 3L conventional chemotherapy treatment is 4–10 months. Few publications report outcomes of patients treated with 3L conventional chemotherapy in the UK.
Aims
To describe real-world clinical outcomes of patients with relapsed or refractory (R/R) LBCL initiating conventional 3L treatment in the UK.
Methods
This multicenter retrospective analysis was conducted across 6 centers in the UK. Eligible patients were ≥18 years of age with a documented diagnosis of LBCL in 2003 or later. Diagnoses included DLBCL not otherwise specified (NOS; de novo or tFL), high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements with DLBCL histology, follicular lymphoma grade 3B, or PMBCL. Patients had to have received 2 prior lines of systemic treatment, which included an anthracycline and anti-CD20–targeting monoclonal antibody (mAb). Patients with primary central nervous system lymphoma or who had received chimeric antigen receptor (CAR) T cell therapy were excluded. Progression-free survival (PFS) was calculated based on available information for response assessments, receipt of subsequent treatment, and death. PFS and OS were summarized from the start of 3L therapy to progression or death using the Kaplan-Meier method.
Results
A total of 129 patients met the stringent eligibility criteria. The median age of patients was 58 years (range, 22–87 years), 64% were male (n=82), 76% had a disease histology of DLBCL NOS (n=98), 76% had an Eastern Cooperative Group performance status of 0–2 (n=98), and 44 of the 66 patients (67%) who had an International Prognostic Index score had a score of 0–2. The median time from diagnosis to start of 3L treatment was 14.6 months (range, 4–161 months). All patients had received rituximab, 11% received prior auto-HSCT (n=14), and 57% were chemotherapy refractory (n=73). The most common 3L treatment regimens were salvage chemotherapy without an anti-CD20 mAb (44%, n=57), salvage chemotherapy with an anti-CD20 mAb (22%, n=28), salvage chemotherapy followed by auto-HSCT (10%, n=13) or allogeneic HSCT (8%, n=10), pixantrone (4%, n=5), and lenalidomide (4%, n=5), respectively. Clinical and/or imaging assessment data related to 3L treatment was available for 104 patients. The overall response rate was 38% (n=40). Median PFS from the start of 3L treatment was 1.97 months (95% CI, 1.68–2.56 months). Median OS from the start of 3L treatment was 7.00 months (95% CI, 4.73–9.23 months). Additional analyses for patient subgroups will be presented.
Conclusion
This UK real-world analysis provides insights into clinical practice and highlights the poor outcomes achieved with conventional (non–CAR T cell) 3L treatment options in the UK, demonstrating the need for more effective treatments in patients with R/R LBCLs.
Keyword(s): Cellular therapy, Lymphoma therapy, Relapsed lymphoma, Survival