Real-world characteristics, treatment patterns, and outcomes of newly diagnosed diffuse large B-cell lymphoma (DLBCL) patients treated in first-line (1L) in the United States (US) community oncology setting.

Abstract

e19069 Background: Most US DLBCL patients receive their care in community practices. In that setting, there is greater variability in patient characteristics, care delivery, and resources that may affect management and outcomes. While 1L therapy with R-CHOP predominates, the approval of Pola-R-CHP expanded options. However, there is limited data characterizing the drivers of treatment patterns and outcomes in the community setting. The objective of this study is to describe real-world clinical profiles and time-to-next-treatment or death (TTNTD) among patients treated with 1L therapy in the US community oncology practice setting. Methods: Patients newly diagnosed with DLBCL (not otherwise specified) who initiated a 1L regimen within the US Oncology Network from January 1, 2020 to January 31, 2025 were included. Structured electronic health record data was analyzed until death or last contact date by September 2025. TTNTD was estimated using Kaplan-Meier methods. Patient characteristics and outcomes were summarized descriptively by 1L regimen (R-CHOP, Pola-R-CHP, or Other). Results: Among the 4,291 eligible patients, the 1L therapies included 3,138 (73%) R-CHOP, 411 (10%) Pola-R-CHP, and 742 (17% overall; 83% R-mini-CHOP and 17% other chemotherapy) Other. Baseline characteristics differed with higher stage in Pola-R-CHP and older age at diagnosis in Other, which was primarily R-mini-CHOP. Adoption of Pola-R-CHP increased from 2% to (2022) to 28% (2024), while R-CHOP declined but remained most used across years (86%-54%). Two-year TTNTD was 70.6% for R-CHOP, 73.6% for Pola-R-CHP, and 47.3% for Other. Median TTNTD was 68.5 months for R-CHOP, not reached for Pola-R-CHP, and 17.9 months for Other. Conclusions: Pola-R-CHP utilization is increasing, but R-CHOP was the most used 1L regimen in the US community setting. While TTNTD is favorable for Pola-R-CHP, high rates of relapse remain, highlighting ongoing need for optimization of frontline therapy and supportive care pathways to improve real-world effectiveness. Patient characteristics and outcomes by 1L treatment. Variable R-CHOP (n=3,138) Pola-R-CHP (n=411) Other (n=742) Median Age (Q1, Q3) 68 (59, 75) 69 (61, 75) 82 (78, 85) Female, n (%) 1,368 (43.6%) 175 (42.6%) 357 (48.1%) Stage (I-II), n (%) 1,029 (32.8%) 42 (10.2%) 215 (29.0%) Stage (III-IV), n (%) 1,482 (47.2%) 294 (71.5%) 388 (52.3%) <2 ECOG, n (%) 1,617 (51.5%) 232 (56.4%) 312 (42.0%) ≥2 ECOG, n (%) 274 (8.7%) 36 (8.8%) 151 (20.4%) TTNTD Events, n (%) 933 (29.7%) 95 (23.1%) 375 (50.5%) Median TTNTD (Months; 95% CI) 68.5 (63.5, NR) NR (34.2, NR) 17.9 (13.5, 26.0) 2-Year TTNTD (95% CI) 70.6% (68.8, 72.3)% 73.6% (68.4, 78.1)% 47.3% (43.2, 51.3)% CI = Confidence interval, ECOG = Eastern Cooperative Oncology Group, NR = Not reached.