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Evaluating Attrition Rates and Treatment Outcomes Among Patients With MCL

Ellen Kurek

According to a studty published in the journal, Value In Health, a continuous decline in real world time to next treatment (rwTINT) and overall survival (OS) emphasized an urgent need for more effective treatments in early lines of therapy (LOT) for patients with mantle cell lymphoma (MCL). In this study, Dr A Husain, Janssen Global Oncology, Toronto, ON, Canada and colleagues evaluated attrition rates and treatment outcomes, by LOT, in patients with MCL  in routine clinical practice.

This retrospective study utilized the Flatiron Health EHR-derived MCL Database involving 3614 patients treated between January 2011 and January 2021, of whom 87% were from a community oncology setting. 

Attrition rate was defined as the percentage of patients who did not have a record of a subsequent LOT, including reasons due to death. Among patients who received a first-line (1L) therapy but without a record of subsequent LOT or death, a minimum of 2-years of follow-up was applied. 

The results revealed that patients 65 years of age or older (1902 patients), 23.8% of 1L-treated patients, 27.5% of 2L-treated patients, and 29.9% of 3L-treated patients died without having received a subsequent LOT; 53.7%, 45.8%, and 44.7% of patients started a subsequent LOT, respectively.

The attrition rates were reported as 46.3% after 1L, 54.2% after 2L, and 55.3% after 3L. For patients younger than 65 years of age (1034 patients), 9.5% of 1L-treated patients, 13.1% of 2L-treated patients, and 18.5% of 3L-treated patients died without having received a subsequent LOT, and the attrition rates were 40-52% across subsequent lines of therapy. Among the 3614 patients, 3-year rwTTNT rates were 41% with 1L treatment, 25% with 2L treatment, and 18% with 3L treatment, while 3-year OS rates were 68%, 49%, and 35%, respectively.

The authors concluded, “In this real-world analysis, high attrition rates were observed in patients with MCL, ranging from 40 to 55%, regardless of age or line of therapy,” adding, “There was a steady decrease in rwTTNT and OS with each successive line of therapy, highlighting the need for more effective treatment options for MCL patients in earlier lines of therapy.” 


Reference

Husain A, Qi K, Zhu A. RWD64 Attrition Rates and Treatment Outcomes during Successive Lines of Therapy in Patients with Mantle Cell Lymphoma in the US. Value in Health. Volume 25, Issue 7, Supplement, July 2022. https://doi.org/10.1016/j.jval.2022.04.1588