Systematic review of outcomes and patient heterogeneity in relapsed or refractory diffuse large B-cell lymphoma

J Comp Eff Res. 2023 Jan;12(1):e220146. doi: 10.2217/cer-2022-0146. Epub 2022 Nov 23.

Abstract

Aim: To evaluate trials of systemic therapies in transplant-ineligible or -experienced, relapsed/refractory diffuse large-B cell lymphoma and the impact of patient characteristics on overall response rate (ORR). Patients & methods: Systematically reviewed multiple databases through 22 July 2021. Analyzed variations in patient characteristics and their relationship with ORR across trials. Results: Among 17 included trials, key patient characteristics varied substantially: primary refractory (0-69%), refractory to last line of therapy (LOT) (12-100%), ≥2 prior LOTs (14-100%), ≥3 prior LOTs (0-64%), IPI ≥3 (23-73%), tumor stage III/IV (50-90%) and median age (56-74 years). ORRs varied substantially (25-83%), correlating with these characteristics. Conclusion: Differences in patient characteristics significantly contribute to the variability in ORR across these trials and should be considered when contextualizing efficacy data.

Keywords: clinical trials; comparative effectiveness research; diffuse large B-cell lymphoma; nonrandomized trials; oncology; randomized controlled trials; refractory; relapsed; systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols*
  • Humans
  • Lymphoma, Large B-Cell, Diffuse* / drug therapy
  • Middle Aged
  • Rituximab / therapeutic use

Substances

  • Rituximab