第三种或随后的治疗线后的现实世界结果:一项丹麦基于189名患有复发/耐药大B细胞淋巴瘤的患者的基于人口的研究
Ahmed Ludvigsen Al-Mashhadi1,2,3, Lasse Hjort Jakobsen1,2,4, Peter Brown5,6
1Department of Haematology, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark.
British journal of haematology
|November 27, 2023
概括
除了二线治疗之外,关于复发性/耐药性扩散性大B细胞淋巴瘤 (DLBCL) 的现实数据有限. 结果通常很差,但在适合疾病有限的患者的密集治疗显示出更好的生存率.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 临床研究 临床研究
背景情况:
- 除了二线治疗之外,复发性/耐药性 (R/R) 扩散性大B细胞淋巴瘤 (DLBCL) 的现实世界结局数据很少.
- 在单臂试验中批准的R/R DLBCL的新疗法需要现实世界的上下文化.
- 了解治疗模式和后期治疗的结果对于患者管理至关重要.
研究的目的:
- 评估R/R DLBCL患者接受第三线或后期 (3L+) 治疗的现实结果.
- 为了确定影响这种患者群体生存的因素.
- 将临床试验数据与现实世界的证据联系起来.
主要方法:
- 对3753名被诊断患有DLBCL的丹麦成年人的医疗记录进行了回顾性审查.
- 纳入标准:接受Rituximab和基于Anthracycline的化疗的患者,在2015年1月1日之后接受3L+治疗.
- 数据分析包括治疗方法,整体存活率 (OS) 和无进展存活率 (PFS).
主要成果:
- 只有189名患者 (平均年龄71岁) 符合3L+治疗的资格标准.
- 对所有患者来说,两年的OS和PFS估计分别为25%和12%.
- 基于的救援疗法显示出改善的结果 (2年OS 49%,PFS 17%).
- 有利的预后因素包括年龄<70,没有中枢神经系统干预,正常的LDH和ECOG<2 (2年OS65%).
结论:
- 一小部分DLBCL患者接受3L+治疗,结果通常不佳.
- 强化治疗,特别是以为基础的救援疗法,可能会改善选择适合患者的结果.
- 年龄,中枢神经系统参与,LDH和ECOG性能状态是第二线治疗之外的R/R DLBCL结果的关键预测因素.
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