COTA, Inc., a real-world data (RWD) and analytics company specializing in oncology, and Memorial Sloan Kettering Cancer Center (MSK) will present data from two Diffuse Large B-Cell Lymphoma (DLBCL) studies at the 66th American Society of Hematology Annual Meeting (ASH) in December 2024. The studies focus on older DLBCL patients, aiming to improve cancer care plans for this often underrepresented demographic.
DLBCL, a blood cancer, frequently affects older individuals. While the median diagnosis age is 66, almost 30% of cases occur in patients over 75. Although curable with chemotherapy in up to 70% of cases, survival rates significantly decline with age. A major challenge is the underrepresentation of older adults in randomized control trials (RCTs). Only 9% of RCT participants are 65 or older, and a mere 1% are over 75. This stems from factors like age, comorbidities, and the need for immediate therapy in aggressive cancer forms, making trial participation difficult. Standard exclusion criteria in clinical trials often prevent older, less fit individuals, particularly those with aggressive subtypes, from participating. Consequently, there’s a lack of clear understanding regarding their care and outcomes.
RWD offers a valuable alternative, providing insights into treatment patterns for older populations and informing future trial designs. It can also illuminate how older patients respond to new treatments and how to manage end-of-life care best. Research presented at ASH revealed that older adults with DLBCL who began treatment immediately after diagnosis had poorer outcomes, including shorter times to needing further therapy and lower overall survival rates, compared to those with a longer interval between diagnosis and initial treatment. These patients also tended to be treated in academic centers, had higher ECOG scores (indicating poorer physical function), and presented with high-risk clinical features.
A second study found that only a small percentage of older DLBCL patients received a documented hospice or palliative care referral. The highest referral rate (38%) was among patients over 90, highlighting the need for research into the value of end-of-life care. This research leverages MSK’s clinical expertise and COTA’s RWD from electronic health records, demonstrating the potential of AI and real-world data to enhance understanding of treatment responses and end-of-life care in older patients. Notably, over 85% of the study data originates from community care sites, reflecting real-world cancer care across America. Including community-based data ensures that insights apply to all demographics, regardless of where they receive treatment. High-quality, representative data can empower cancer researchers and oncologists with more accurate outcome predictions, facilitate better-shared decision-making, and personalize palliative oncology and end-of-life care. The research teams hope these findings will stimulate further research and equip oncologists with stronger clinical evidence to treat older patients throughout their care journey.
Jon Napitupulu is Director of Media Relations at The Clinical Trial Vanguard. Jon, a computer data scientist, focuses on the latest clinical trial industry news and trends.
