Overview
High-grade B-cell lymphoma (HGBCL) is an aggressive malignancy with no established standard frontline or salvage regimen. This study used the US Flatiron Health Research Database, comprising over 82,000 patients with large B-cell lymphoma, to describe real-world treatment trends and survival among 3,964 patients diagnosed across two time periods: Early-era (2016–2021, n=2,199) and Late-era (2022–2026, n=1,765).
Frontline therapy selection remained consistent across eras, most commonly R-CHOP (~29%) and R-EPOCH variants (~35%). In second-line and subsequent settings, treatment patterns shifted away from hematopoietic cell transplantation (5.1% in Early-era vs 1.4% in Late-era) toward CAR T therapy (7.1% vs 14%) and bispecific antibodies (1.0% vs 11%). In descriptive Kaplan-Meier analyses, median 1L real-world overall survival (51.1 months overall) and progression-free survival (20.1 months overall) appeared similar between eras.
Why this matters
This research outlines evolving treatment management for HGBCL in US practice, showing an increased adoption of CAR T and bispecific antibodies in later lines of therapy alongside stable frontline practice patterns.