Management of Canadian Patients With Refractory or Relapsed Diffuse Large B-Cell Lymphoma in the Real World: A Subanalysis of the RE-MIND2 Study
Menée au Canada dans un contexte de vie réelle à partir de données portant sur 109 patients atteints d'un lymphome diffus à grandes cellules B, cette étude de cohorte rétrospective analyse les caractéristiques des traitements
Background: In the current Canadian treatment landscape for relapsed or refractory diffuse large B-cell lymphoma (R/R DLBCL), eligibility for autologous stem cell transplantation (ASCT) guides the choice of salvage treatment. CD19 chimeric antigen receptor T-cell (CAR-T) therapies have improved outcomes in patients with chemorefractory DLBCL, but access is limited to eligible patients. This subanalysis of the RE-MIND2 observational retrospective cohort study investigated treatment patterns for R/R DLBCL in Canada.
Patients and Methods: Data from patients enrolled in RE-MIND2 treated between 2010 and 2020 at 2 Canadian centers were retrospectively collected from health records. Descriptive statistics were used to analyze baseline characteristics, treatment initiated, and duration of treatment by line of therapy.
Results: One hundred and nine patients were included; 74.2% of patients were eligible for ASCT as 2 L therapy and 45.4% received transplants. ASCT eligibility for third- (3 L) and fourth-line (4 L) therapy declined to 17.1% and 5.9%, respectively. Patients received a wide variety of treatments in 3 L and 4 L. CAR-T therapy became available in 3 L and 4 L by the end of 2019. Median durations of treatment were <2.6 months in all lines of therapy; median time to next treatment ranged from 3.4 months in 4 L to 5.3 months in 2 L.
Conclusion: Results of our study support that ASCT-ineligible patients have a poor prognosis with conventional salvage chemotherapy. Prior to the availability of novel immunotherapies, no apparent standard of care was observed for Canadian patients with R/R DLBCL who were ineligible for or did not receive ASCT, especially after 2 L treatment.
The Oncologist , résumé, 2025