Survival Patients Newly Diagnosed with Diffuse Large B-Cell Lymphoma (DLBCL) - Real World Evidence from Germany

Background: Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma with increasing incidence. Although the burden of disease is high, only limited current real-world data on survival analysis, especially survival time, of German patients with DLBCL is available. This retrospective claims-based analysis was conducted to describe real-world survival evidence and treatment patterns of patients with DLBCL in Germany.

Patients and Methods: Using a large claims database of the German statutory health insurance with 6.7 million enrollees between 2010 and 2019, we identified patients who were newly diagnosed with DLBCL (index date) and had no other cancer co-morbidity. Treatment lines were identified based on a predefined set of medications categorized by established DLBCL treatment recommendations. Overall survival (OS) from index and from the end of each therapy line was plotted by means of the Kaplan-Meier estimator, both for the overall cohort and stratified by treatment regimen. To identify a therapy regimen that consists of a combination of different compounds or treatments, all drugs that were added within 30 days after treatment initiation are considered as part of the same regimen and line of therapy. All treatments of interest which are documented during this time slot beginning with the date of the first prescription will be summarized to a therapy line. This therapy line is ended if a new drug is added after the first 30 days of treatment initiation. The end date of the therapy line is then defined as the day before the prescription date of the new drug. Furthermore, a therapy line is ended if a treatment gap of 90 days is observed.

Results: 2,495 incident DLBCL patients were eligible for the study. After index, 1,991 patients started a first-line, 868 a second-line, and 354 a third-line therapy. In first line, 79.4% of patients received a Rituximab containing regimen. This share declined to 59.5% in second, and to 45.7% in third line therapy, respectively. 4.9% of the overall cohort receives a stem cell transplantation (either autologous or allogeneic). This share is lower in first line (2.1%), compared to second line (4.6%), and third line therapy (7.9%). Overall, median OS after index was 96.0 months. For patients receiving at least one line of therapy, median OS was 103.9 month while it was only 15.8 months for those who remained untreated. After first, second, and third line therapy, median survival was 98.0 months, 60.3 months, and 32.3 months, respectively.

Conclusion: DLBCL associated mortality is still high, especially in later treatment lines. Therefore, new innovative therapy options are awaited.

Borchmann:Novarts: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Bristol-Myers Squibb: Honoraria, Membership on an entity's Board of Directors or advisory committees; Miltenyi Biotec: Honoraria, Membership on an entity's Board of Directors or advisory committees. Papadimitrious:Miltenyi Biomedicine GmbH: Current Employment. Riou:Miltenyi Biomedicine GmbH: Current Employment. Mahlich:Miltenyi Biomedicine GmbH: Current Employment. Werner:Team Gesundheit GmbH: Current Employment; Miltenyi Biomedicine GmbH: Other: Data Analysis.