{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T10:35:33Z","timestamp":1777890933979,"version":"3.51.4"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>R\/R DLBCL is an aggressive malignancy with limited treatment options. Novel immunotherapies have improved outcomes in selected clinical\u2010trial populations, but their effectiveness in real\u2010world settings remains unclear. Their substantial costs also pose challenges for healthcare systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This exploratory study evaluated the efficacy and costs of available therapies in a real\u2010world population. Two retrospective analysis approaches were used: First, we compared calendar\u2010based cohorts: A conventional\u2010treatment period (1 January 2018\u201331 December 2019), which predates EMA approval of Polatuzumab\u2010vedotin, and a modern\u2010treatment period (1 January 2020\u201331 December 2022). Second, because treatments overlapped across periods, we additionally grouped patients by therapy exposure and compared those receiving any modern therapy at any stage with those treated exclusively with conventional regimens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Comparing the calendar\u2010based periods provided limited insights, as therapies unavailable in the earlier period could still be used in subsequent treatment lines. In contrast, grouping patients by exposure to modern therapy at any stage showed a clear survival benefit: Median OS was 20 vs. 5\u2009months (95% CI: 1.8\u201338.2 vs. 3.0\u20137.0;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022). This advantage was associated with significantly higher mean costs (\u20ac178,513.08 vs. \u20ac15,185.08;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), resulting in an incremental cost of \u20ac10,889 per additional month of survival.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Modern therapies for r\/r DLBCL have significantly improved survival rates, but their high costs necessitate careful cost\u2010effectiveness assessments to ensure they are integrated optimally into clinical practice. Additionally, our findings indicate that calendar\u2010based comparisons can be misleading, since novel treatments do not simply \u201cstart\u201d and \u201cstop\u201d at approval dates\u2014a crucial methodological insight that is highly generalizable to real\u2010world evidence studies. Grouping patients by actual therapy exposure offers a more accurate evaluation of clinical benefits and economic impact when new treatments become routine. Achieving equitable access to treatment while maintaining healthcare sustainability will require coordinated efforts among clinicians, researchers, and policymakers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71667","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T22:48:26Z","timestamp":1773010106000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Retrospective Cohort Analysis of Treatment Patterns, Survival, and Cost\u2010Effectiveness in Relapsed\/Refractory Diffuse Large B\u2010Cell Lymphoma in Lower Austria (2018\u20132022)"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8701-2412","authenticated-orcid":false,"given":"Josef","family":"Singer","sequence":"first","affiliation":[{"name":"Karl Landsteiner University of Health Sciences  Krems Austria"},{"name":"Department of Internal Medicine II University Hospital Krems, Karl Landsteiner University of Health Sciences  Krems Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Gottsauner\u2010Wolf","sequence":"additional","affiliation":[{"name":"Strategy and Quality Medicine \u2013 Medical Strategy and Development Landesgesundheitsagentur Nieder\u00f6sterreich  St. P\u00f6lten Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5772-5307","authenticated-orcid":false,"given":"Doris A.","family":"Behrens","sequence":"additional","affiliation":[{"name":"Department for Economy and Health University for Continuing Education Krems  Krems Austria"},{"name":"Employee Wellbeing Service Aneurin Bevan University Health Board  Cwmbr\u00e2n UK"},{"name":"School of Mathematics Cardiff University  Cardiff 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