Patient preferences regarding bispecific antibody (BsAb) treatment schedules and clinical profiles in second-line or later (2L+) diffuse large B-cell lymphoma (DLBCL).

Abstract

e23129 Background: Recent trials have examined BsAb combinations in 2L+ relapsed/refractory (R/R) DLBCL: glofitamab plus gemcitabine-oxaliplatin (Glofit-GemOx) in STARGLO and mosunetuzumab plus polatuzumab vedotin (Mosun-Pola) in SUNMO are characterized by less frequent dosing vs epcoritamab plus gemcitabine-oxaliplatin (Epcor-GemOx) in EPCORE NHL-2 and by fixed-duration treatment (FDT). A survey was developed to understand patient preferences for clinical and treatment (Tx) attributes in the R/R DLBCL setting. Methods: An online rolling survey (Dec 2024–Oct 2025) was completed by US adults with DLBCL who had received ≥1 Tx. Preferences were assessed through direct elicitation (selecting between pairs of fixed Tx profiles) and object-case best-worst scaling (BWS; to identify the most and least burdensome process-related attributes). Tx attributes included administration mode, Tx duration, administration frequency in 1 year, risk of cytokine release syndrome (CRS), progression-free survival (PFS), and overall survival (OS). Results: Overall, 175 patients (pts) completed the survey (mean age: 65 years; male: 50%; White: 58%). Mean time from diagnosis to survey completion was 4.5 years; 40% were on active Tx; 65% had prior immunotherapy; 78% reported changing Tx ≥2 times due to disease progression. Of 115 pts who answered the direct elicitation question, 84% preferred a Glofit-GemOx-like (intravenous [IV], FDT, less frequent Tx, longer PFS/OS, lower CRS risk) vs an Epcor-GemOx-like profile (IV and subcutaneous, treat-to-progression [TTP], more frequent Tx, shorter PFS/OS, higher CRS risk). In addition, of 50 pts comparing between Mosun-Pola vs Epcor-GemOx, 86% preferred a Mosun-Pola-like (no chemotherapy, FDT, less frequent Tx, similar PFS/OS, lower CRS risk) vs an Epcor-GemOx-like profile (includes chemotherapy, TTP, more frequent Tx, similar PFS/OS, higher CRS risk). Among pts who chose the Glofit-GemOx-like (n=96) and Mosun-Pola-like (n=43) profiles, 77% and 72%, respectively, would choose that option if starting Tx today. When ranking features on a scale of 1 to 8 (1 = most important) between Mosun-Pola-like and Epcor-GemOx-like profiles, the three most important features were PFS (mean [standard deviation]: 2.4 [1.5]), OS (2.8 [1.7]), and Tx duration (3.9 [2.0]). BWS results revealed that longer travel times to receive Tx was most burdensome and having medical appointments for fewer days in a year was least burdensome. Conclusions: Among 2L+ multi-agent BsAb combinations for R/R DLBCL, pts showed a clear preference for a FDT option with less frequent administration and reduced CRS risk vs a TTP option with more frequent administration and higher CRS risk. These patient-centred data provide essential insights for clinicians and pts to make informed, preference-aligned, shared decisions in the R/R DLBCL setting.