Outcomes in relapsed/refractory diffuse large B-cell lymphoma in an Asian tertiary cancer center: real-world interventions as benchmark for novel therapy

Background

Recent advances have led to the approval of several new therapies for relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL). However, real-world data for treatment patterns and outcomes in R/R DLBCL in Asian countries are lacking, limiting the benchmarking of novel treatments.

Patients and methods

We conducted a retrospective single-center cohort study including 227 patients with R/R DLBCL diagnosed from 2010 to 2022. Outcomes including progression-free survival (PFS) and overall survival (OS) were assessed.

Results

In the overall cohort, median OS was 13.5 months and 5-year OS was 29.8% from the time of first relapse. Median time to first relapse from completion of first-line immunochemotherapy was 7.03 months (range 0-148.4 months). Time to first relapse was significantly associated with OS outcomes. Patients who had earlier relapse, defined as 12 months or less from first-line treatment, had worse OS at 8.6 months, as compared with patients who relapsed >12 months after first-line treatment, who had OS of 34.2 months (hazard ratio 1.73, 95% confidence interval 1.26-2.37, P = 0.007). Median PFS was 3.2 months as compared with 15.3 months, respectively. The majority (n = 121, 53.3%) were transplant-ineligible and only 44 (19.4%) were transplanted. The median PFS for non-transplant recipients was 3.5 months versus 34.4 months for transplant recipients. The median OS for non-transplant recipients was 8.5 months versus 114.1 months for transplant recipients.

Conclusion

Poor outcomes remain for patients with R/R DLBCL. Novel therapeutics including bispecifics and CAR-T may improve outcomes of these patients.