Analysis Group Inc., Los Angeles, CA, USA.
ADC Therapeutics Inc., New Providence, NJ, USA.
Curr Med Res Opin. 2021 Oct;37(10):1789-1798. doi: 10.1080/03007995.2021.1957806. Epub 2021 Aug 17.
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.
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.
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 ( = 55), targeted therapies were most commonly used (36.4%), and the median treatment duration was 2.5 months.
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+.
嵌合抗原受体 T 细胞（CAR-T）疗法问世以来，已有多种新型疗法获批用于治疗复发/难治性弥漫性大 B 细胞淋巴瘤（R/R DLBCL）。本研究旨在描述 CAR-T 获批后 R/R DLBCL 患者的特征和治疗模式。
使用 IQVIA PharMetrics Plus 的行政索赔数据（2014 年 1 月 1 日至 2020 年 3 月 31 日），确定自 2017 年 10 月 18 日起接受三线或以上治疗（3L+）的 R/R DLBCL 成年患者。治疗分为化疗/化疗免疫治疗（CT/CIT）、靶向治疗、CAR-T 和干细胞移植（SCT）。描述了接受 3L 的患者的治疗分布、CT/CIT 和靶向治疗的治疗持续时间以及下一线治疗的开始情况；对 4L 进行了重复分析。
共有 145 名患者在 2017 年 10 月 18 日至 2020 年 3 月 31 日期间接受了 3L 治疗。平均年龄为 57 岁，34%为女性。3L 中采用 CT/CIT（44.9%）、靶向治疗（26.9%）、CAR-T（17.2%）和 SCT（11.0%）。CT/CIT 和靶向治疗联合的中位治疗持续时间为 2.9 个月。中位随访 5.8 个月时，31%的患者开始 4L 治疗。在接受 4L（n=55）的患者中，靶向治疗最常用（36.4%），中位治疗持续时间为 2.5 个月。
CAR-T 获批后，大多数患者在 3L 和 4L 中接受 CT/CIT 或靶向治疗，但大多数开具的靶向治疗并非针对 DLBCL。治疗持续时间较短。在短时间的随访期间，相当大比例的患者进入下一治疗线（LOT）。本研究强调了 R/R DLBCL 患者在 3L+中需要更有效的治疗。
