A retrospective medical chart review presented at the 2024 ASH Annual Meeting revealed the real-world effectiveness of tafasitamab-cxix (Monjuvi) in US patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL). The study, which included 181 patients, highlighted the clinical benefits and identified factors influencing treatment outcomes in a real-world setting.
Key Findings on Tafasitamab Efficacy
At a median follow-up of 14.7 months from the start of tafasitamab treatment, the real-world progression-free survival (PFS) was 11.3 months (95% CI, 9.8-13.6) in the overall patient population. The real-world overall survival (OS) reached 24.8 months (95% CI, 17.8-NE). The overall response rate (ORR) was 73.5%, comprising a complete response (CR) rate of 23.2% and a partial response (PR) rate of 50.3%. Among the 133 patients who achieved a CR or PR, the duration of response (DOR) was 9.6 months (95% CI, 8.3-13.3).
Factors Influencing Progression and Mortality
Multivariable analysis identified several factors significantly associated with an increased risk of disease progression. These included receiving tafasitamab in the third to fifth line of therapy (HR, 1.79; 95% CI, 1.20-2.66; P = .004), having Ann Arbor stage III to IV disease (HR, 0.30; 95% CI, 0.10-0.95; P = .041), increasing Charlson Comorbidity Index scores (HR, 1.43; 95% CI, 1.03-1.97; P = .033), and the presence of bulky disease (HR, 1.96; 95% CI, 1.26-3.05; P = .003).
A Cox proportional hazards model also revealed factors linked to increased mortality risk. These included receiving tafasitamab in later lines of therapy (HR, 2.39; 95% CI, 1.46-3.93; P < .001), increasing age (HR, 1.06; 95% CI, 1.03-1.09; P < .001), an ECOG performance status of 2 or higher (HR, 3.57; 95% CI, 2.13-5.97; P < .001), and bulky disease (HR, 2.22; 95% CI, 1.27-3.87; P = .005).
Insights from the Lead Investigator
Dr. Kim Saverno, PhD, of Incyte Corporation, the lead study author, highlighted the significance of the findings. "The additional follow-up from the initial data collection allowed for a more robust evaluation of the real-world effectiveness of tafasitamab in patients with relapsed or refractory DLBCL, predominantly in the community practice setting," she stated in her poster presentation. "These results support a real-world clinical benefit for tafasitamab, with the greatest benefit observed when [the agent] was received in second vs later lines of therapy."
Study Design and Patient Characteristics
The retrospective, multisite medical chart review involved 23 physicians from Cardinal Health’s Oncology Provider Extended Network, with 83% practicing in community settings. The study included 181 patients who initiated tafasitamab treatment (with or without lenalidomide) for relapsed/refractory DLBCL on or after October 21, 2020, were at least 18 years old, and had a minimum follow-up of 4 months. The median age at tafasitamab initiation was 71.1 years, with most patients being White (64.1%) and male (56.4%).
Treatment Outcomes and Response Rates
Patients receiving tafasitamab in the second line of therapy (n = 130) demonstrated a real-world ORR of 78.5%, including a CR rate of 27.7% and a PR rate of 50.8%. In contrast, patients receiving the immunotherapy in the third line (n = 43) had a real-world ORR of 62.8%, with a CR rate of 11.6% and a PR rate of 51.2%.
The median real-world DOR was 19.2 months (95% CI, 8.8-NE) in patients achieving a CR and 8.5 months (95% CI, 6.8-10.0) in those achieving a PR.
Limitations
Dr. Saverno acknowledged the study's limitations, including those inherent to real-world studies such as unobserved and missing data, and the small number of participating oncologists, which may not fully represent treatment patterns across the US.
