Real life clinical outcomes of relapsed/refractory diffuse large B cell lymphoma in the rituximab era: The STRIDER study

Author:

Dogliotti Irene1ORCID,Peri Veronica12,Clerico Michele1,Vassallo Francesco3,Musto Davide2,Mercadante Silvio2,Ragaini Simone12,Botto Barbara4,Levis Mario5,Novo Mattia4,Ghislieri Marco67,Molinaro Luca8,Mortara Umberto8,Consoli Chiara12,Lonardo Alessio2,Bondielli Giulia2,Ferrero Simone12,Freilone Roberto4,Ricardi Umberto5,Bruno Benedetto12ORCID,Cavallo Federica12ORCID

Affiliation:

1. Division of Hematology University Hospital A.O.U. “Città della Salute e della Scienza” Turin Italy

2. Division of Hematology U, Department of Molecular Biotechnologies and Health Sciences University of Turin Turin Italy

3. Division of Hematology Ospedale Santa Croce e Carle Cuneo Italy

4. Division of Hematology AOU “Città della Salute e della Scienza di Torino” Turin Italy

5. Division of Radiotherapy, Department of Oncology. University Hospital A.O.U. “Città della Salute e della Scienza” Turin Italy

6. Department of Electronics and Telecommunications Politecnico di Torino Turin Italy

7. PolitoBIOMed Lab, Politecnico di Torino Turin Italy

8. Division of Pathology AOU “Città della Salute e della Scienza di Torino” Turin Italy

Abstract

AbstractBackgroundRelapse and refractory (R/R) rates after first‐line R‐CHOP in diffuse large B cell lymphomas (DLBCL) are ~40% and ~15% respectively.AimsWe conducted a retrospective real‐world analysis aimed at evaluating clinical outcomes of R/R DLBCL patients.Material and MethodsOverall, 403 consecutive DLBCL patients treated in two large hematological centers in Torino, Italy were reviewed.ResultsAt a median follow up of 50 months, 5‐year overall survival from diagnosis (OS‐1) was 66.5%, and 2‐year progression free survival (PFS‐1) was 68%. 134 (34.4%) patients relapsed (n = 46, 11.8%) or were refractory (n = 88, 22.6%) to R‐CHOP. Most employed salvage treatments included platinum salt‐based regimens in 38/134 (28.4%), lenalidomide in 14 (10.4%). Median OS and PFS after disease relapse or progression (OS‐2 and PFS‐2) were 6.7 and 5.1 months respectively. No significant difference in overall response rate, OS‐2 or PFS‐2 in patients treated with platinum‐based regimens versus other regimens was observed. By multivariate analysis, age between 60 and 80 years, germinal center B cell type cell of origin and extranodal involvement of <2 sites were associated with better OS‐2.DiscussionOur findings confirm very poor outcomes of R/R DLBCL in the rituximab era. Widespread approval by national Medicine Agencies of novel treatments such as CAR‐T cells and bispecific antibodies as second‐line is eagerly awaited to improve these outcomes.

Publisher

Wiley

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