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Abstract
Objective
Several novel treatments have been approved for relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL) since chimeric antigen receptor T-cell (CAR-T) therapy became available. The objective of this study was to describe characteristics and treatment patterns in patients with R/R DLBCL post-CAR-T approval.
Methods
Adult patients with R/R DLBCL who initiated third-line treatment or later (3 L+) since 18 October 2017 were identified using administrative claims from IQVIA PharMetrics Plus (1 January 2014–31 March 2020). Treatments were categorized as chemotherapy/chemoimmunotherapy (CT/CIT), targeted therapies, CAR-T and stem cell transplant (SCT). Treatment distribution, treatment duration of CT/CIT and targeted therapies, and initiation of next-line therapy were described for patients receiving 3 L; analyses were repeated for 4 L.
Results
A total of 145 patients received 3 L between 18 October 2017 and 31 March 2020. Mean age was 57 years, and 34% were female. CT/CIT (44.9%), targeted therapies (26.9%), CAR-T (17.2%) and SCT (11.0%) were administered in 3 L. The median treatment duration was 2.9 months for CT/CIT and targeted therapies combined. 31% of patients initiated 4 L within a median follow-up of 5.8 months. Among patients who received 4 L (N = 55), targeted therapies were most commonly used (36.4%), and the median treatment duration was 2.5 months.
Conclusions
Post-CAR-T approval, the majority of patients were treated with CT/CIT or targeted therapies in 3 L and 4 L, though most of the targeted therapies prescribed are not indicated for DLBCL. Treatment duration was short. A high proportion of patients moved to the next line of therapy (LOT) during a short follow-up period. This study highlights the unmet need for more effective treatments for patients with R/R DLBCL in 3 L+.
Transparency
Declaration of funding
This paper was supported by ADC Therapeutics Inc.; the study sponsor was involved in all stages of the study research and preparation.
Declaration of financial/other relationships
J.X., A.W., E.X.D. and A.N. have disclosed that they are employees of Analysis Group Inc., which received consultancy fees from ADC Therapeutics Inc., for conducting research analysis. L.L. and L.C. have disclosed that they are employees of ADC Therapeutics Inc., and own ADC Therapeutics stock or stock options. L.J.N. has disclosed that she received research funding from Bristol Myers Squibb/Celgene, Epizyme, Genentech, Janssen, Merck, Novartis, Pfizer and TG Therapeutics, as well as honoraria from ADC Therapeutics Inc., Bayer, Bristol Myers Squibb, Celgene, Epizyme, Genentech, Janssen, Morphosys, Novartis, Pfizer and TG Therapeutics. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.
Author contributions
All authors have contributed to conception and design of the study; analysis and interpretation of the data; the drafting of the paper and revising it critically for intellectual content. All authors provided final approval of the version to be published.
Acknowledgements
Medical writing support in the form of copyediting, editorial and production assistance was provided by Loraine Georgy PhD, an employee of Analysis Group Inc., which received consultancy fees from ADC Therapeutics Inc., for conducting research analysis.
Notes
i IQVIA PharMetrics Plus is a registered trademark of IQVIA Inc., Plymouth Meeting, PA, USA.
ii NCCN is a registered trademark of National Comprehensive Cancer Network, Plymouth Meeting, PA, USA.