Background BsAbs for R/R DLBCL have diverse attributes, which may influence adherence and outcomes. This study aimed to describe patients' (pts) preferences for treatment (Tx) attributes mirroring those of glofitamab (Glofit)- and epcoritamab (Epcor)-containing regimens in the second- and third-line or later (2L+ and 3L+) R/R DLBCL Tx setting.

Methods An online rolling survey was completed between Dec 2024 and Mar 2025 by US adults recruited from the Global Perspectives database of physicians who referred pts with DLBCL who had received ≥1 Tx. Tx preferences were assessed through 1) direct elicitation, where pts were presented with questions, each with pairs of fixed Tx profiles defined by attributes associated with Glofit- or Epcor-containing regimens, and 2) an object-case best-worse scaling (BWS) to identify the most and least burdensome Tx attributes. Tx attributes (informed by clinical trial results) included mode of administration (subcutaneous [SC] vs intravenous [IV]), Tx duration (based on mean number of cycles converted to months), frequency of administration in 1 year, progression-free survival (PFS), overall survival (OS), and risk and monitoring of cytokine release syndrome (CRS).

Pts were first presented with Tx profiles based on mode of administration, Tx duration, and frequency of administration in 1 year in the 3L+ setting, assuming similar efficacy and safety. Preferences were assessed again with the addition of PFS, OS, and risk and monitoring of CRS in the 2L+ setting. Descriptive analyses were used to describe the proportion of pts selecting each of the Tx profiles in the direct elicitation and those ranking each Tx attribute as most and least burdensome in the BWS.

Results In this analysis, 125 pts completed the survey. Mean age was 66 years (range: 49–80), 48% were male, 54% were White, mean time from diagnosis to survey completion was 4 years, and 42% were on ≥1 active Tx (immunotherapy: 70%, chemotherapy: 25%, targeted Tx: 9%).

When responding to questions on 3L+ Tx profiles (n=65), 69% vs 31% preferred a Tx with Glofit-like attributes (IV administration, fixed duration [FD], and less frequent administrations) vs Epcor-like attributes (SC injection, treat to progression (TTP), and more frequent administrations), respectively. Among pts who preferred a Tx with Glofit-like vs Epcor-like attributes (n=45), 60% would be very/extremely likely to choose a Glofit-like Tx if starting a new Tx today. When outpatient/at-home CRS monitoring was added as an off-label Epcor-like attribute, 63% still opted for the Glofit-like profile, which had in-hospital CRS monitoring for 24 hours as an attribute. When responding to an overall question on Tx duration (assuming similar efficacy, safety, and mode of administration; N=125), 38% preferred FD, 35% had no preference, 19% preferred TTP, and 7% were unsure/did not know. When responding to questions on 2L+ Tx profiles (n=65), 89% vs 11% preferred a Tx with Glofit-GemOx-like attributes (IV administration, FD, less frequent administration, longer PFS and OS, and lower risk of CRS) vs Epcor-GemOx-like attributes (IV infusion and SC injection, TTP, more frequent administrations, shorter PFS and OS, and higher risk of CRS), respectively. Among pts who preferred a Tx with Glofit-GemOx-like vs Epcor-GemOx-like attributes (n=58), 78% responded they would likely choose a Glofit-GemOx-like Tx if starting a new Tx today.

From the object-case BWS, four of the most burdensome Tx attributes included having medical appointments for more days in a year, longer travel times to receive Tx, SC injection lasting half a day and taken until progression, and an IV infusion lasting a whole day for a FD. The least burdensome Tx attributes included having medical appointments for fewer days in a year, shorter travel times to receive Tx, and at-home CRS monitoring.Conclusions Pts with R/R DLBCL reported preferences for Tx attributes similar to Glofit vs Epcor in both monotherapy and combination Tx settings. Pts preferred a FD Tx, with less frequent administration and reduced risk of CRS vs a TTP Tx with more frequent administration and higher risk of CRS. BWS results were similar: pts found attributes associated with Glofit to be less burdensome vs Epcor, including shorter travel times to receive Tx and fewer medical visits in a year. These results may facilitate discussions about Tx priorities and guide shared decision-making as BsAbs become increasingly available for pts with R/R DLBCL.

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2025
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