Survey Reveals Physician Preferences for Treating Relapsed/Refractory Diffuse Large B-Cell Lymphoma

Results of a survey suggest that physicians treating patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) in the third line prefer treatments that show efficacy, alignment with patient preferences, and capacity for outpatient administration. Survey results were presented in a poster at the 2023 NCCN Annual Conference by Wei Gao, PhD, of Analysis Group, Inc., in Boston, Massachusetts, and colleagues.

Additionally, treatment until progression was preferred over a fixed-duration approach in general, and this preference was especially pronounced for treatment of certain patient subgroups. These included patients who have had prior relapses on fixed doses (56.0%), those who have had refractory disease with previous therapy (49.3%), those who have shown progression after stem cell transplantation or chimeric antigen receptor T-cell (CAR-T) therapy (45.3% and 49.3%, respectively), and those with a need for frequent monitoring (46.7%).

The real-world, web-based survey included hematologists/oncologists who had been practicing for at least a year and who had treated at least 3 patients with R/R DLBCL during the prior year. These physicians also had experience with third-line treatment of R/R DLBCL and with prescribing/referring patients for CAR-T treatment. Data were obtained regarding physician characteristics, third-line treatment preferences, and use of CAR-T therapy.

There were 75 respondents, among whom 62.7% had more than 10 years of experience. Over the prior year, respondents had treated a mean of 39.9 patients who had R/R DLBCL. Respondents indicated they prescribed CAR-T to 36.6% of patients after second-line therapy failure, and 49.1% of patients were referred to a CAR-T treatment center. Most patients (65.3%) for whom CAR-T was recommended did undergo CAR-T therapy. Reasons given for not receiving CAR-T therapy among eligible patients included a lack of willingness to travel (49.3%), ineligibility determined after referral (48.0%), or patients having other treatment preferences (37.3%).

Physicians were also asked about preferences for intravenous versus subcutaneous treatment. Almost half (44.0%) of respondents had no preference, whereas 33.3% preferred subcutaneous administration, and 22.7% preferred intravenous administration. More than half (58.7%) reported that they perceived a patient preference for subcutaneous treatment, while 12.0% perceived a patient preference for intravenous treatment, and 29.3% perceived no preference among patients.

The researchers conducting the study noted that CAR-T therapy is approved in the third-line setting in DLBCL but that there are multiple barriers to its use. They indicated future studies are warranted to evaluate physician preferences for treating R/R DLBCL as the treatment landscape changes.

Disclosures: The presenters declared affiliations with Analysis Group, AbbVie, Alkemi, and Genmab.

Reference

Gao W, Gaburo K, Lahue BJ, Davies K, Ukropec J, Jun M. Assessment of physician treatment preferences for relapsed or refractory diffuse large B-cell lymphoma. Poster presented at: 2023 NCCN Annual Conference; March 31-April 2, 2023. Abstract HSR23-118.