In a study published in PharmacoEconomics-Open, researchers conducted a systematic literature review to gain a better understanding of the health-related quality of life (HRQoL) evidence for treatments in relapsed or refractory (R/R) large B-cell lymphoma (LBCL) and to find related health utility values.
The authors wrote, “A number of new agents, combinations, and regimens are currently under investigation for the treatment of R/R LBCL. In this ever-expanding treatment landscape, there is a need for consolidated HRQoL evidence in R/R LBCL to help patients and physicians make treatment decisions.”
For this study, randomized and nonrandomized studies and economic evaluations reporting health state utility values or HRQoL measures were eligible for inclusion in this systematic review. Several therapies were included, such as chimeric antigen receptor (CAR) T-cell therapies, novel therapies (e.g., polatuzumab vedotin and bendamustine), salvage therapies, and rituximab.
The researchers explored literature published between January 1, 2003, and May 2, 2022. Two independent reviewers evaluated the literature, and quality assessments of the evidence were conducted in agreement with health technology assessment recommendations from the National Institute for Health and Care Excellence.
The researchers found 33 unique studies reporting HRQoL, including 15 economic studies that reported health state utility values, nine clinical trials, seven health technology assessment reports, and one each of a vignette-based study and a point-in-time survey.
The researchers indicated that enhancements in general and/or lymphoma-specific HRQoL measures were observed with CAR T-cell therapy in both the second-line and third-line or later settings. For CAR T-cell therapies, on-treatment utility values ranged from 0.50 to 0.74. Data revealed that across studies, values for remission/progression-free survival (0.70-0.90) and for disease progression (0.39-0.59) were comparable. Regarding novel therapies, utility values were found to be 0.83 for progression-free survival and ranged from 0.39 to 0.71 for disease progression. For salvage chemotherapy, on-treatment utility values ranged from 0.63 to 0.67.
Based on their findings, the authors wrote, “Overall, the evidence synthesized in this SLR provides a comprehensive understanding of the HRQOoL evidence in R/R LBCL. This article identified several sources for utility values in the published literature showing variation in the HRQoL outcomes for patients across a variety of therapeutics.”
The authors also concluded that treatment of R/R LBCL with CAR T-cell therapies was associated with improved health utility values, diverse results were observed for novel therapies and salvage therapies, and more data are warranted as new therapies are prescribed in this patient population to inform treatment decision-making.
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