Next-Generation Prognostic Assessment for Diffuse Large B-Cell Lymphoma

Staton, Ashley D.; Koff, Jean L.; Chen, Qiushi; Ayer, Turgay; Flowers, Christopher R.

doi:10.2217/fon.15.144

Cited by 9 publications

(3 citation statements)

References 132 publications

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“…These studies have demonstrated the great level of heterogeneity characterizing the genetic landscape of DLBCL and prompted further investigation. The identification of clinically relevant biomarkers can form the basis for the development of new drugs, aid clinicians in choosing the appropriate therapies and establishing reliable prognostic models (208)(209)(210).…”

Section: Next-generation Sequencing Of Dlbclmentioning

confidence: 99%

Genetics of Diffuse Large B-Cell Lymphoma

Cummin

Johnson

2018

N Engl J Med

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Section: Next-generation Sequencing Of Dlbclmentioning

confidence: 99%

Genetics of Diffuse Large B-Cell Lymphoma

Cummin

Johnson

2018

N Engl J Med

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“…11 Centroblastic lymphoma is the most common subtype with better prognosis compared with immunoblastic and anaplastic variants of DLBCL. 12 A case of diffuse large B-cell lymphoma of the mandible in an 18-year-old male patient is reported.…”

Section: Introductionmentioning

confidence: 99%

Primary Diffuse Large B-cell Lymphoma involving the Mandible

Alshahrani¹,

Aljabab²,

Motabi³

et al. 2015

The Journal of Contemporary Dental Practice

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Lymphomas of the oral cavity are rare and typically present as intraosseous lesions that are most commonly diffuse large B-cell type. Diffuse large B-cell lymphoma (DLBCL) is an aggressive B-cell lymphoma histologically characterized by diffuse proliferation of large neoplastic B-lymphoid cells with a nuclear size equal to or exceeding normal histiocytic nuclei. A case of DLBCL of the mandible in an 18 years old male patient is presented. This report discusses this rare malignancy, including clinical presentation, histopathologic features, immunologic profile, treatment and prognosis. Though lymphoma of mandible is rare, it must be considered in differential diagnosis of swellings arising in the region.

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“…1 , 2 Of these patients, 60% will receive first line chemoimmunotherapy and be successfully treated. 3 – 5 The remaining will experience relapsed or refractory (r/r) disease and require subsequent therapy. Standard therapy for r/r DLBCL is salvage chemotherapy followed by high-dose therapy and autologous stem-cell transplantation (SCT).…”

mentioning

confidence: 99%

CAR T-cell Therapy for Diffuse Large B-cell Lymphoma in Canada: A Cost-Utility Analysis

Masucci,

Tian,

Tully

et al. 2024

Med Decis Making

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Background Chimeric antigen receptor (CAR) T-cell therapy is a novel cell therapy for treating non-Hodgkin lymphoma. The development of CAR T-cell therapy has transformed oncology treatment by offering a potential cure. However, due to the high cost of these therapies, and the large number of eligible patients, decision makers are faced with difficult funding decisions. Our objective was to assess the cost-effectiveness of tisagenlecleucel for adults with relapsed/refractory diffuse large B-cell lymphoma in Canada using updated survival data from the recent JULIET trial. Methods We developed an individual-simulated discrete event simulation model to assess the costs and quality-adjusted life-years (QALY) of tisagenlecleucel compared with salvage chemotherapy. Survival estimates were obtained from a published clinical trial and retrospective analysis. If patients remained progression free for 5 y, they were assumed to be in long-term remission. Costing and utility data were obtained from reports and published sources. A Canadian health care payer perspective was used, and outcomes were modeled over a lifetime horizon. Costs and outcomes were discounted at 1.5% annually, with costs reported in 2021 Canadian dollars. A probabilistic analysis was used, and model parameters were varied in 1-way sensitivity analyses and scenario analyses. Results After we incorporated the latest clinical evidence, tisagenlecleucel led to an additional cost of $503,417 and additional effectiveness of 2.48 QALYs, with an incremental cost-effectiveness ratio of $202,991 compared with salvage chemotherapy. At a willingness-to-pay threshold of $100,000/QALY, tisagenlecleucel had a 0% likelihood of being cost-effective. Conclusions At the current drug price, tisagenlecleucel was not found to be a cost-effective option. These results heavily depend on assumptions regarding long-term survival and the price of CAR T. Real-world evidence is needed to reduce uncertainty. Highlights For patients with diffuse large B-cell lymphoma who failed 2 or more lines of systemic therapy, CAR T was not found to be a cost-effective treatment option at a willingness-to-pay threshold of $100,000. These results heavily depend on the expected long-term survival. The uncertainty in the model may be improved using real-world evidence reported in the future.

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Next-Generation Prognostic Assessment for Diffuse Large B-Cell Lymphoma

Cited by 9 publications

References 132 publications

Genetics of Diffuse Large B-Cell Lymphoma

Genetics of Diffuse Large B-Cell Lymphoma

Primary Diffuse Large B-cell Lymphoma involving the Mandible

CAR T-cell Therapy for Diffuse Large B-cell Lymphoma in Canada: A Cost-Utility Analysis

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