Outcomes of Relapsed or Refractory Diffuse Large B-Cell Lymphoma Treated With R-GemOx: A Multicenter Cohort Study

Area of Science:

• Hematology
• Oncology
• Clinical Trials

Background:

• Rituximab, gemcitabine, and oxaliplatin (R-GemOx) is a standard chemoimmunotherapy for relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL).
• Limited real-world data exist for R-GemOx in R/R DLBCL, especially across different treatment strategies and patient demographics.

Purpose of the Study:

• To evaluate the real-world effectiveness of R-GemOx in a large cohort of patients with R/R DLBCL and high-grade B-cell lymphoma.
• To analyze outcomes based on treatment intent (e.g., bridge to transplant vs. standalone therapy) and patient age (≥70 years).

Main Methods:

• A multicenter retrospective study involving 183 patients with R/R DLBCL treated with R-GemOx across eight US academic centers (LEO CReWE).
• Subgroup analyses were performed for patients not intended for autologous stem cell transplant (ASCT) or CAR T-cell therapy (n=100), those using R-GemOx as a bridge to ASCT or CAR T (n=83), and elderly patients (≥70 years, n=71).

Main Results:

• The overall response rate (ORR) for all patients was 45%, with a complete response (CR) rate of 29%. Median event-free survival (EFS) was 2.3 months, and median overall survival (OS) was 13.5 months.
• Patients receiving R-GemOx as a bridge to ASCT or CAR T showed higher ORR (57%) and CR (36%) rates, with improved median EFS (3.5 months) and OS (17.4 months) compared to those not receiving consolidation.
• Elderly patients (≥70 years) achieved an ORR of 53% and CR of 33%, with median EFS of 2.2 months and OS of 13.9 months, indicating comparable outcomes to the overall cohort.

Conclusions:

• R-GemOx demonstrates moderate efficacy in R/R DLBCL, with outcomes significantly influenced by its use as a bridge to potentially curative therapies like ASCT or CAR T-cell therapy.
• The regimen appears feasible and effective in elderly patients, providing a valuable treatment option in this population.
• These real-world data establish a benchmark for R-GemOx in the evolving treatment landscape of R/R DLBCL.