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. 2020 Dec;37(12):4877-4893.
doi: 10.1007/s12325-020-01507-7. Epub 2020 Oct 1.

A Systematic Review of the Clinical Efficacy of Treatments in Relapsed or Refractory Diffuse Large B Cell Lymphoma

Per-Olof Thuresson  1 , Nancy Vander Velde  2 , Palvi Gupta  3 , Jonathan Talbot  4
Affiliations

A Systematic Review of the Clinical Efficacy of Treatments in Relapsed or Refractory Diffuse Large B Cell Lymphoma

Per-Olof Thuresson et al. Adv Ther. 2020 Dec.

Abstract

Introduction: Novel treatment options are needed to improve outcomes in transplant-ineligible relapsed/refractory (R/R) diffuse large B cell lymphoma (DLBCL). This systematic literature review evaluated clinical evidence on treatments for patients with R/R DLBCL ineligible for, or relapsed following, stem cell transplantation.

Methods: We assessed the feasibility of conducting an indirect treatment comparison (ITC) or network meta-analysis (NMA) to evaluate the relative efficacy and safety of polatuzumab vedotin in combination with bendamustine + rituximab versus other relevant treatments.

Results: Thirty-seven studies were identified, of which 20 were eligible [seven randomized, controlled trials (RCTs); 13 observational/single-arm trials]. Due to a lack of RCTs, an ITC/NMA summary of the relative efficacy and safety of the treatment options was not possible. Only two of the seven RCTs had positive outcomes.

Conclusions: These findings highlight the paucity of published RCTs to establish the comparative efficacy of treatments for transplant-ineligible R/R DLBCL and lack of standard of care in this setting.

Keywords: Diffuse large B cell lymphoma; Polatuzumab vedotin; Systematic literature review.

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Figures

Fig. 1
Fig. 1
PRISMA flow diagram of included studies. PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses; SCT stem cell transplant
Fig. 2
Fig. 2
Assessment criteria used to assess complete response (by investigator) in the included studies. Pettengell et al. 2016 [21] included patients who were rituximab naïve and rituximab pretreated (54% of the pixantrone group and 56% of the comparator group received rituximab). CR complete response; IWG International Working Group
See this image and copyright information in PMC

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