Survival outcomes of patients newly diagnosed with diffuse large B-cell lymphoma: real-world evidence from a German claims database

Borchmann, Peter; Heger, Jan‐Michel; Mahlich, Jörg; Papadimitrious, Michael S.; Riou, Sybille; Werner, Barbara G.

doi:10.1007/s00432-023-04660-y

Cited by 4 publications

(5 citation statements)

References 32 publications

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“…We cannot rule out the possibility that in some cases, combination treatments such as R-CHOP were coded as chemotherapy in the inpatient setting, without the separate OPS code for rituximab (OPS 6-001.h, 6-001.j). Additionally, our results are consistent with Borchmann et al, which also found that approximately 20% of patients received regimens without rituximab in the first line [ 25 ]. Approximately 5% of all treated patients were given CD20 antibodies as monotherapy in the first-line treatment.…”

Section: Discussionsupporting

confidence: 92%

“…This is in part due to the approximately 20% of the included population who did not receive any DLBCL treatment during follow-up. This finding is in line with Borchmann et al, a study that used a different German claims dataset to examine survival outcomes of patients with DLBCL and which also found that 20% of included patients did not receive a DLBCL treatment regimen [ 25 ]. A study using US insurance data also described that approximately 25% of patients with DLBCL receive no treatment [ 35 ].…”

Section: Discussionsupporting

confidence: 88%

“…It is possible that the relatively short median time between treatment lines is due to our treatment line algorithm, which was used due to the lack of clinical information in claims data. However, our algorithm is consistent with methods used for other real-world studies [ 25 , 26 ]. Short times between treatment lines may be indicative of refractory rather than relapsed disease.…”

Section: Discussionsupporting

confidence: 73%

“…To identify lines of treatment (LOTs) [ 25 , 26 , 31 ], a treatment algorithm was developed based on recent guidelines for the treatment of DLBCL [ 32 ] and input from a clinical expert. The start of the first-line therapy (LOT1) was the first date on which the patient received a DLBCL-related treatment in the inpatient or outpatient setting.…”

Section: Methodsmentioning

confidence: 99%

“…Information on the epidemiology of the disease [ 4 , 6 ] and treatment regimens used in real-world settings [ 17 , 25 , 26 ] are limited. Therefore, this study complements the existing body of real-world evidence and investigates the prevalence, incidence, and current treatment patterns (treatment regimens, switches, and duration) for DLBCL in a real-world setting based on a patient population identified in a large German claims dataset.…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology and Real-World Treatment of Incident Diffuse Large B-cell Lymphoma (DLBCL): A German Claims Data Analysis

Pacis,

Bolzani,

Heuck

et al. 2024

Oncol Ther

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Introduction The objective of this study was to investigate the prevalence, incidence, and treatment patterns (treatment regimens, switches, duration) for diffuse large B-cell lymphoma (DLBCL) in a real-world setting. Methods This was a retrospective German claims data analysis of patients with DLBCL diagnosed between January 1, 2012, and December 31, 2020. The prevalence and cumulative incidence of DLBCL were found for 2019/2020. Line of treatment (LOT) and treatment setting from first DLBCL diagnosis to end of follow-up were described. Kaplan–Meier overall survival (OS) estimates since DLBCL diagnosis and start of treatment lines were calculated. Results Overall, 2633 incident DLBCL cases were identified (median age 75 years, 51% male). Of these, 2119 patients received at least one DLBCL-related treatment (LOT1), and 1567 patients died during follow-up. In 2019/2020, the prevalence and cumulative incidence of DLBCL was 34.8/36.7 per 100,000 patients and 14.0/12.7 per 100,000 patients, respectively. For LOT1, 1922 patients were given a chemotherapy-based regimen (1530 with CD20 antibodies). A total of 403 patients were administered a second line (LOT2), of which 183 patients received a CD20 antibody-containing chemotherapy regimen and 100 patients received stem cell transplantation or chimeric antigen receptor (CAR)-T therapy. Of the 136 LOT3+ treatments, 74 were chemotherapy regimens (54 with CD20 antibodies) and 18 were kinase inhibitors. The median time between treatment lines was less than 6 months. Among patients with at least LOT2, approximately 50% received more than one LOT during the first year after diagnosis. Approximately 25% of treated patients died within 6 months of treatment initiation. Of the 2633 included patients, the median OS from diagnosis was 31.0 months (treated patients: 46.8 months, untreated patients: 3.0 months). Conclusions Despite advances in the field, high unmet medical need in DLBCL remains. The treatment landscape is very heterogeneous, particularly in second- or later-line treatments, with few patients receiving potentially curative treatment beyond the first line. Treatment for DLBCL, particularly for transplant-ineligible patients, remains challenging. Supplementary Information The online version contains supplementary material available at 10.1007/s40487-024-00265-8.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 88%