{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:14:38Z","timestamp":1790802878872,"version":"4.1.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":40,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100004331","name":"Johnson and Johnson","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004331","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Blood Cancer J."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Treatment options for diffuse large B-cell lymphoma (DLBCL) have expanded, but real-world data on treatment patterns and outcomes remain limited. This study examined real-world outcomes in DLBCL patients treated between 10\/1\/2015 and 6\/30\/2024. Patients were stratified by lines of therapy (LOT) and treatments (1L rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone [R-CHOP]; 2L stem cell transplant [SCT]; and chimeric antigen receptor T-cell [CAR T] therapy (any LOT). Variables were reported descriptively. Time-to-event outcomes were assessed using the Kaplan-Meier method. LOT data from 9875 patients were included. R-CHOP-based regimens were the most common 1L treatment (61.7%\u201367.3% in 2016\u20132023; 49.4% in 2024). Conventional chemoimmunotherapy use decreased in 2L (81.6% in 2016 to 41.9% in 2024) and 3L (47.6% in 2016 to 22.1% in 2024), while novel therapies increased (43.0% in 2L and 55.9% in 3L in 2024). Median overall survival declined across LOT (1L: 58.1 months; 2L: 30.0 months), as did median time to next treatment (1L: 36.1 months; 2L: 10.6 months). Twelve-month treatment failure rates were 36.0% after 1L, 51.8% after 2L, and 42.2% after CAR T. Among CAR T recipients, 93 received one of 36 distinct subsequent regimens, indicating no standard of care. These findings highlight the unmet needs in DLBCL.<\/jats:p>","DOI":"10.1038\/s41408-025-01412-8","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T03:55:20Z","timestamp":1764906920000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Real-world treatment patterns and clinical outcomes among patients with diffuse large B-cell lymphoma in a US healthcare claims database"],"prefix":"10.1038","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3365-6562","authenticated-orcid":false,"given":"Mazyar","family":"Shadman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7431-0983","authenticated-orcid":false,"given":"Jennifer S.","family":"Harper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Bokun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Graf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxiao","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,5]]},"reference":[{"key":"1412_CR1","unstructured":"Cancer stat facts: non-Hodgkin lymphoma [cited 2024 November 16]. Available from: https:\/\/seer.cancer.gov\/statfacts\/html\/nhl.html."},{"key":"1412_CR2","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1002\/ajh.26151","volume":"96","author":"S Susanibar-Adaniya","year":"2021","unstructured":"Susanibar-Adaniya S, Barta SK. 2021 Update on Diffuse large B cell lymphoma: a review of current data and potential applications on risk stratification and management. Am J Hematol. 2021;96:617\u201329.","journal-title":"Am J Hematol"},{"key":"1412_CR3","doi-asserted-by":"publisher","first-page":"2040","DOI":"10.1182\/blood-2010-03-276246","volume":"116","author":"B Coiffier","year":"2010","unstructured":"Coiffier B, Thieblemont C, Van Den Neste E, Lepeu G, Plantier I, Castaigne S, et al. Long-term outcome of patients in the LNH-98.5 trial, the first randomized study comparing rituximab-CHOP to standard CHOP chemotherapy in DLBCL patients: a study by the Groupe d\u2019Etudes des Lymphomes de l\u2019Adulte. Blood. 2010;116:2040\u20135.","journal-title":"Blood"},{"key":"1412_CR4","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1016\/S1470-2045(06)70664-7","volume":"7","author":"M Pfreundschuh","year":"2006","unstructured":"Pfreundschuh M, Trumper L, Osterborg A, Pettengell R, Trneny M, Imrie K, et al. CHOP-like chemotherapy plus rituximab versus CHOP-like chemotherapy alone in young patients with good-prognosis diffuse large-B-cell lymphoma: a randomised controlled trial by the MabThera International Trial (MInT) Group. Lancet Oncol. 2006;7:379\u201391.","journal-title":"Lancet Oncol"},{"key":"1412_CR5","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/S1470-2045(08)70002-0","volume":"9","author":"M Pfreundschuh","year":"2008","unstructured":"Pfreundschuh M, Schubert J, Ziepert M, Schmits R, Mohren M, Lengfelder E, et al. Six versus eight cycles of bi-weekly CHOP-14 with or without rituximab in elderly patients with aggressive CD20+ B-cell lymphomas: a randomised controlled trial (RICOVER-60). Lancet Oncol. 2008;9:105\u201316.","journal-title":"Lancet Oncol"},{"key":"1412_CR6","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1056\/NEJMra2027612","volume":"384","author":"LH Sehn","year":"2021","unstructured":"Sehn LH, Salles G. Diffuse large B-cell lymphoma. N Engl J Med. 2021;384:842\u201358.","journal-title":"N Engl J Med"},{"key":"1412_CR7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2022.102443","volume":"110","author":"S Poletto","year":"2022","unstructured":"Poletto S, Novo M, Paruzzo L, Frascione PMM, Vitolo U. Treatment strategies for patients with diffuse large B-cell lymphoma. Cancer Treat Rev. 2022;110:102443.","journal-title":"Cancer Treat Rev"},{"key":"1412_CR8","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-024-00997-w","volume":"14","author":"A Trabolsi","year":"2024","unstructured":"Trabolsi A, Arumov A, Schatz JH. Bispecific antibodies and CAR-T cells: dueling immunotherapies for large B-cell lymphomas. Blood Cancer J. 2024;14:27.","journal-title":"Blood Cancer J"},{"key":"1412_CR9","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1002\/hon.3143","volume":"41","author":"G Varma","year":"2023","unstructured":"Varma G, Goldstein J, Advani RH. Novel agents in relapsed\/refractory diffuse large B-cell lymphoma. Hematol Oncol. 2023;41:92\u2013106.","journal-title":"Hematol Oncol"},{"key":"1412_CR10","doi-asserted-by":"publisher","first-page":"5521","DOI":"10.1158\/1078-0432.CCR-24-1729","volume":"30","author":"M Sarraf Yazdy","year":"2024","unstructured":"Sarraf Yazdy M, Kasamon YL, Gu W, Rodriguez LR, Jin S, Bhatnagar V. et al. FDA approval summary: polatuzumab vedotin in the first-line treatment of select large B-cell lymphomas. Clin Cancer Res. 2024;30:5521\u20136.","journal-title":"Clin Cancer Res"},{"key":"1412_CR11","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.7173","volume":"13","author":"HM Sineshaw","year":"2024","unstructured":"Sineshaw HM, Zettler CM, Prescott J, Garg M, Chakraborty S, Sarpong EM, et al. Real-world patient characteristics, treatment patterns, and treatment outcomes of patients with diffuse large B-cell lymphoma by line of therapy. Cancer Med. 2024;13:e7173.","journal-title":"Cancer Med"},{"key":"1412_CR12","doi-asserted-by":"publisher","first-page":"317","DOI":"10.2217\/fon-2023-0191","volume":"20","author":"M Garg","year":"2024","unstructured":"Garg M, Puckett J, Kamal-Bahl S, Raut M, Ryland KE, Doshi JA, et al. Real-world treatment patterns, survival, health resource use and costs among Medicare beneficiaries with diffuse large B-cell lymphoma. Future Oncol. 2024;20:317\u201328.","journal-title":"Future Oncol"},{"key":"1412_CR13","doi-asserted-by":"publisher","first-page":"2630","DOI":"10.1007\/s12325-022-02087-4","volume":"39","author":"JJ Jalbert","year":"2022","unstructured":"Jalbert JJ, Wu N, Chen CI, Ambati S, Ge W, Arnason JE. Real-world treatment patterns after CD19-directed CAR T cell therapy among patients with diffuse large B cell lymphoma. Adv Ther. 2022;39:2630\u201340.","journal-title":"Adv Ther"},{"key":"1412_CR14","doi-asserted-by":"publisher","first-page":"1789","DOI":"10.1080\/03007995.2021.1957806","volume":"37","author":"J Xie","year":"2021","unstructured":"Xie J, Wu A, Liao L, Nastoupil LJ, Du EX, Noman A, et al. Characteristics and treatment patterns of relapsed\/refractory diffuse large B-cell lymphoma in patients receiving >\/=3 therapy lines in post-CAR-T era. Curr Med Res Opin. 2021;37:1789\u201398.","journal-title":"Curr Med Res Opin"},{"key":"1412_CR15","doi-asserted-by":"publisher","first-page":"e817","DOI":"10.1002\/onco.13721","volume":"26","author":"X Yang","year":"2021","unstructured":"Yang X, Laliberte F, Germain G, Raut M, Duh MS, Sen SS, et al. Real-World characteristics, treatment patterns, health care resource use, and costs of patients with diffuse large B-cell lymphoma in the U.S. Oncologist. 2021;26:e817\u2013e26.","journal-title":"Oncologist"},{"key":"1412_CR16","unstructured":"FDA approves axicabtagene ciloleucel for large B-cell lymphoma [cited 2025 April 24]. Available from: https:\/\/www.fda.gov\/drugs\/resources-information-approved-drugs\/fda-approves-axicabtagene-ciloleucel-large-b-cell-lymphoma"},{"key":"1412_CR17","unstructured":"FDA approves axicabtagene ciloleucel for second-line treatment of large B-cell lymphoma [cited 2025 April 24]. Available from: https:\/\/www.fda.gov\/drugs\/resources-information-approved-drugs\/fda-approves-axicabtagene-ciloleucel-second-line-treatment-large-b-cell-lymphoma"},{"key":"1412_CR18","unstructured":"Optum\u2019s de-identified Clinformatics\u00ae Data Mart Database [cited 2025 January 29]. Available from: https:\/\/www.optum.com\/content\/dam\/optum\/resources\/productSheets\/Clinformatics_for_Data_Mart.pdf."}],"container-title":["Blood Cancer Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41408-025-01412-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41408-025-01412-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41408-025-01412-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T15:25:47Z","timestamp":1768404347000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41408-025-01412-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,5]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["1412"],"URL":"https:\/\/doi.org\/10.1038\/s41408-025-01412-8","relation":{},"ISSN":["2044-5385"],"issn-type":[{"value":"2044-5385","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,5]]},"assertion":[{"value":"28 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 October 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 November 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 December 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"MS has received consultancy fees and\/or research funding from AbbVie, Genentech, AstraZeneca, Genmab, Janssen, BeiGene, Bristol Myers Squibb, Morphosys\/Incyte, Kite Pharma, Eli Lilly, Fate Therapeutics, Nurix, Merck, Mustang Bio, Vincerx, and Koi Biotherapeutics. Employment: Bristol Myers Squibb (spouse). JSH, AB, CX, PL, GG, and XL are employees of Johnson & Johnson and may hold company stock. JSH holds a patent assigned to Johnson & Johnson.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"14"}}