Patient preferences for attributes of bispecific antibodies for relapse/refractory diffuse large B-cell lymphoma in...

Two recently approved bispecific antibodies (bsAbs) for relapsed/refractory diffuse large B-cell lymphoma (DLBCL) include epcoritamab (subcutaneous, SC) administered until progression (TTP), and glofitamab (intravenous, IV) for fixed duration (FTD). Understanding patient preferences for treatment attributes is critical for patient-centered decision-making.

A discrete-choice experiment among 123 DLBCL patients assessed preferences for bsAbs across six attributes: median overall survival (OS, 12- vs 18-months), 24-month complete response (CR) (55% vs 62%), grade 3-4 cytokine release syndrome risk (CRS, 2% vs 5%), CRS-related hospitalization (2% vs 56%), duration (FTD vs TTP) and administration (SC vs IV). Preference weights were estimated using conditional logistic regression.

CRS and CRS-related hospitalization were the strongest drivers of preferences (1.83, P < 0.001), followed by OS (1.14, P < 0.001), CR (1.13, P < 0.001), duration (0.48, P < 0.001), and administration (0.02, P = 0.877). Patients favored FTD, but preferred TTP if it reduced CRS (79.3%) or improved survival (65.8%). Patients indicated the importance of efficacy attributes (OS, 86.2%; CR, 85.4%) and quality of life (QoL, 71.5%) in decision-making.

Efficacy and safety were the most important factors, along with QoL. Patients favored FTD but were willing to tradeoff for TTP with increased efficacy or safety. These findings may guide physician/patient discussions in therapy selection.