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在美国医疗保健索赔数据库中,扩散型大B细胞淋巴瘤患者的真实世界治疗模式和临床结果
Mazyar Shadman1,2, Jennifer S Harper3, Alex Bokun4
1Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA. mshadman@gmail.com.
Blood cancer journal
|December 4, 2025
概括
在现实世界中,扩散性大B细胞淋巴瘤 (DLBCL) 治疗显示,随着治疗线路的增加,生存率下降. 新型疗法正在上升,但对于后续治疗的护理标准,特别是对仿真抗原受体T细胞治疗后的护理标准,仍然难以捉摸.
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:
- 扩散性大B细胞淋巴瘤 (DLBCL) 治疗格局正在演变.
- 现有DLBCL治疗模式和结果的现实数据有限.
- 了解治疗趋势对于改善患者护理至关重要.
研究的目的:
- 检查DLBCL患者的现实世界治疗模式和结果.
- 分析一线 (1L),二线 (2L) 和三线 (3L) 疗法的趋势.
- 评估不同治疗线的生存率和治疗失败率.
主要方法:
- 在2015年10月1日至2024年6月30日期间接受治疗的9875名DLBCL患者的回顾性分析.
- 根据治疗线 (LOT) 和特定治疗方法 (例如R-CHOP,SCT,CAR T细胞疗法) 的分层.
- 描述性统计和Kaplan-Meier方法用于时间到事件结果.
主要成果:
- 基于R-CHOP的疗法对于1L治疗仍然很常见,但最近它们的使用量有所下降.
- 传统化学免疫疗法在2L和3L下降,新疗法相应增加.
- 整个LOT的平均整体存活率和下一次治疗的时间均下降,12个月治疗失败率显著.
- 在CAR T细胞治疗后的后续疗程中显著的异质性表明没有确立的护理标准.
结论:
- 现实世界DLBCL治疗显示了向新型疗法的转变,特别是在后期的治疗线上.
- 随着治疗线路的增加,生存结果似乎在下降.
- 对于标准化和有效的治疗策略有着至关重要的未满足的需求,特别是在DLBCL中使用CAR T细胞治疗后.
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