The prognostic value of POD24 in relapsed/refractory follicular lymphoma-A SCHOLAR-5 analysis

Follicular lymphoma (FL) has a heterogeneous prognosis. Progression within 24 months of starting front-line therapy (POD24) is prognostic of overall survival (OS). Despite its prognostic value in early lines, the role of POD24 in relapsed/refractory (R/R) patients initiating later lines of therapy (LoTs) is unknown.

We analyzed the SCHOLAR-5 real-world cohort to investigate whether POD24 is prognostic in patients with R/R FL initiating ≥3rd LoT.

Among the 128 SCHOLAR-5 patients, 34 patients experienced POD24. POD24 patients received their ≥3 LoT after a shorter time compared with non-POD24 patients (median 42.0 months [range: 8.8‒17.8] vs. 109.9 months [range: 29.6‒310.2]). Using a time-dependent multivariate Cox model, POD24 was predictive of shorter OS from initiation of ≥3rd LoT with a hazard ratio (HR) of 2.44 (95% confidence interval [CI]: 1.20‒4.96). For progression-free survival, using a multivariate repeated-measures Cox model, the effect was similar but not statistically significant (HR: 1.45; 95% CI: 0.94‒2.11).

This study demonstrates that among patients with R/R FL initiating a ≥3rd LoT, POD24 patients reach these LoTs sooner after diagnosis and POD24 remains prognostic of subsequent OS. This suggests that POD24 status can inform clinical decision making in this population.