Epidemiology and Real-World Treatment of Incident Diffuse Large B-cell Lymphoma (DLBCL): A German Claims Data Analysis

Scarlette Pacis; Anna Bolzani; Alexander Heuck; Klaus Gossens; Mathias Kruse; Björn Fritz; Ulf Maywald; Thomas Wilke; Christian Kunz

doi:10.1007/s40487-024-00265-8

Epidemiology and Real-World Treatment of Incident Diffuse Large B-cell Lymphoma (DLBCL): A German Claims Data Analysis

Oncol Ther. 2024 Jun;12(2):293-309. doi: 10.1007/s40487-024-00265-8. Epub 2024 Feb 20.

Authors

Scarlette Pacis¹, Anna Bolzani², Alexander Heuck³, Klaus Gossens³, Mathias Kruse³, Björn Fritz³, Ulf Maywald⁴, Thomas Wilke⁵, Christian Kunz⁶

Affiliations

¹ Cytel Inc., Potsdamer Strasse 58, 10785, Berlin, Germany. scarlette.pacis@cytel.com.
² Cytel Inc., Potsdamer Strasse 58, 10785, Berlin, Germany.
³ AbbVie Deutschland GmbH and Co. KG, Wiesbaden, Germany.
⁴ AOK PLUS, Dresden, Germany.
⁵ Institut für Pharmakoökonomie und Arzneimittellogistik e.V. (IPAM), Wismar, Germany.
⁶ Westpfalz Klinikum, Westpfalz, Germany.

Abstract

Introduction: The objective of this study was to investigate the prevalence, incidence, and treatment patterns (treatment regimens, switches, duration) for diffuse large B-cell lymphoma (DLBCL) in a real-world setting.

Methods: This was a retrospective German claims data analysis of patients with DLBCL diagnosed between January 1, 2012, and December 31, 2020. The prevalence and cumulative incidence of DLBCL were found for 2019/2020. Line of treatment (LOT) and treatment setting from first DLBCL diagnosis to end of follow-up were described. Kaplan-Meier overall survival (OS) estimates since DLBCL diagnosis and start of treatment lines were calculated.

Results: Overall, 2633 incident DLBCL cases were identified (median age 75 years, 51% male). Of these, 2119 patients received at least one DLBCL-related treatment (LOT1), and 1567 patients died during follow-up. In 2019/2020, the prevalence and cumulative incidence of DLBCL was 34.8/36.7 per 100,000 patients and 14.0/12.7 per 100,000 patients, respectively. For LOT1, 1922 patients were given a chemotherapy-based regimen (1530 with CD20 antibodies). A total of 403 patients were administered a second line (LOT2), of which 183 patients received a CD20 antibody-containing chemotherapy regimen and 100 patients received stem cell transplantation or chimeric antigen receptor (CAR)-T therapy. Of the 136 LOT3+ treatments, 74 were chemotherapy regimens (54 with CD20 antibodies) and 18 were kinase inhibitors. The median time between treatment lines was less than 6 months. Among patients with at least LOT2, approximately 50% received more than one LOT during the first year after diagnosis. Approximately 25% of treated patients died within 6 months of treatment initiation. Of the 2633 included patients, the median OS from diagnosis was 31.0 months (treated patients: 46.8 months, untreated patients: 3.0 months).

Conclusions: Despite advances in the field, high unmet medical need in DLBCL remains. The treatment landscape is very heterogeneous, particularly in second- or later-line treatments, with few patients receiving potentially curative treatment beyond the first line. Treatment for DLBCL, particularly for transplant-ineligible patients, remains challenging.

Keywords: DLBCL; Diffuse large B-cell lymphoma; Overall survival; Treatment lines; Treatment patterns.