Historic Real-World Outcomes and Future Benchmarks for Patients with Diffuse Large B-Cell Lymphoma Receiving First- and Second-Line Therapy in Austria - a Large Single-Center Experience.

Abstract

BackgroundDiffuse large B-cell lymphoma (DLBCL) is the most common form of non-Hodgkin-lymphoma. Although it can be cured in many patients, a significant proportion of patients fail the primary treatment and require second-line treatment. Currently, only limited data on real-world outcomes with standard therapies in Austrian patients with DLBCL are available, and while novel therapies are emerging, no historical benchmarks have been established to serve as a reference for these novel treatments.MethodsWe performed a retrospective, single-center analysis of patients with DLBCL diagnosed between 2010 and 2018 who had been treated with standard therapies. To establish efficacy benchmarks for novel therapies, we applied both clinical-trial and real-world-derived criteria to analyze the outcomes of patients potentially eligible for novel or future treatments.ResultsAlthough many patients can be cured with frontline therapy, outcomes are poor, especially in high-risk patients. Patients failing frontline therapy, especially those fulfilling the chimeric antigen-receptor (CAR) T-cell eligibility criteria, had dismal outcomes, and very few patients achieved long-term remission. Our data provide benchmark outcomes for patients eligible for novel treatments such as antibody-drug-conjugate (ADC) or CAR T-cell therapy-based treatments for potential future comparative analyses.ConclusionsPatients with DLBCL treated in Austria showed comparable outcomes to those reported in other real-world studies. Overall, standard chemotherapy-based approaches provide unsatisfactory outcomes in high-risk patients and patients in whom frontline therapy fails. Because many patients are now eligible for alternative first- and second-line treatments, such as ADC-based or CAR T-cell therapy, our efficacy benchmarks can serve for the future evaluation of these therapies in the Austrian healthcare environment.