Comparative Effectiveness of Tafasitamab Plus Lenalidomide versus Ifosfamide, Carboplatin, Etoposide-Based...

L-MIND trial has demonstrated efficacy of tafasitamab plus lenalidomide in patients with relapsed/refractory diffuse large B-cell lymphoma (r/r DLBCL). However, real-world evidence comparing tafasitamab plus lenalidomide to standard salvage therapies remains limited. Therefore, we conducted an external control arm study to evaluate clinical effectiveness of tafasitamab plus lenalidomide compared with ICE (ifosfamide, carboplatin, etoposide) regimen in South Korea.

Individual patient-level data from L-MIND trial and Samsung Medical Center-Lymphoma Cohort Studies (SMC-LCS) registry in South Korea were analyzed to identify DLBCL patients who received tafasitamab plus lenalidomide or ICE as second- to fourth-line therapy. Primary endpoint was overall survival (OS), while secondary endpoints included progression-free survival (PFS), time to next treatment (TTNT), duration of response (DoR), objective response rate (ORR), and complete response rate (CRR). After applying inverse probability of treatment weighting (IPTW), time-to-event and binary outcomes were analyzed using Cox and logistic regression models, respectively.

A total of 76 patients in L-MIND and 39 patients in SMC-LCS were analyzed. After IPTW, median OS was 34.1 months (95% CI, 18.6-NR) for tafasitamab plus lenalidomide and 6.4 months (0.3-13.9) for ICE (hazard ratio [HR], 0.33; 95% CI, 0.20-0.53). HRs were 0.33 (95% CI, 0.20-0.54) for PFS, 0.42 (0.26-0.66) for TTNT, and 0.17 (0.08-0.35) for DoR. Odds ratios were 3.17 (1.37-7.32) for ORR, and 2.87 (1.06-7.78) for CRR.

Tafasitamab plus lenalidomide showed favorable outcomes over ICE, suggesting a clinically meaningful treatment option for r/r DLBCL in South Korea.