ABSTRACT
Introduction: Non-Hodgkin lymphoma (NHL) constitutes ~40% of hematologic malignancies and, in 2020, resulted in 19,940 deaths in the USA. The most common NHL subtypes are diffuse large B-cell lymphoma (DLBCL), including primary mediastinal large B-cell lymphoma (PMBCL), and follicular lymphoma (FL). Although a majority of patients respond to standard-of-care therapy, many patients with NHL eventually relapse, highlighting the need for additional treatments. Real-world data regarding the safety and efficacy of emerging therapies in the relapsed/refractory (R/R) population, and the association between treatment patterns and patient outcomes, are limited. These data could provide unique insights to clinical and health-related quality of life (HRQoL) outcomes in patients with DLBCL, FL, or PMBCL treated with emerging therapies, especially novel options such as chimeric antigen receptor (CAR) T cell therapies. Methods: The Connect ® Lymphoma Disease Registry (NCT04982471) is a US-based, multicenter, prospective observational cohort study of patients with R/R NHL (DLBCL, FL, and PMBCL). Approximately 2100 patients ≥ 18 years of age from ~200 community oncology (~80%) or academic (~20%) sites will be enrolled over a ~3-year period. Patients with histologically confirmed NHL subtypes will be enrolled into 1 of 4 cohorts: first R/R DLBCL, second R/R DLBCL, first R/R FL, or first R/R PMBCL (Figure). Patients will be required to have begun second- (first R/R) or third- (second R/R) line systemic treatment within 60 days prior to enrollment. Patients receiving treatment for any active malignancy other than DLBCL, FL, or PMBCL at the time of enrollment, or who are diagnosed with any other malignancy in the 6 months prior to enrollment, will be excluded. All treatment and management decisions will be determined by the practicing clinicians. Patients may undergo hematopoietic stem cell transplantation, CAR T cell therapy, or other treatments at other sites while participating in this study. Patients will be followed from enrollment for up to 5 years or until death, withdrawal of consent, loss to follow-up, or study termination, whichever occurs first. Data collection will occur at enrollment (baseline) and then every ~3 months. The main objectives of the Connect ® Registry are to describe patient characteristics, practice patterns, and factors associated with treatment choice, sequencing, and effectiveness in NHL subtypes. Secondary objectives include describing treatment regimen safety, patient-reported outcomes (PROs) including HRQoL, and healthcare resource utilization outcomes. Exploratory objectives include tumor and blood biomarker evaluation and understanding the availability of social support and its impact on long-term treatment decision-making. Case report forms will be used to collect clinical and treatment data, including baseline demographics, clinical characteristics, treatment details and response, and socioeconomic factors. Outcome measures for efficacy will be progression-free survival, event-free survival, objective response rate, time to next treatment, and overall survival. The availability of social support will be assessed via a specific questionnaire administered at baseline. General (EQ-5D-5L) and disease-specific (FACT-Lym) questionnaires will also be administered. Patients may also optionally agree to release tumor biopsies and blood samples for biomarker analysis. Clinicians will be required to report serious adverse events (AEs), secondary primary malignancies, and confirmed COVID-19 infections within 24 hours. Non-serious AEs of interest include grade 1-3 cytokine release syndrome, grade 1-3 neurotoxicity, grade 3 colitis, grade 3 arrhythmia, grade 3 hemorrhage. Other AEs of interest to be collected include grade 3 hypogammaglobulinemia, prolonged grade 3 cytopenia, and grade 3 infections. Data collected in the Connect ® Registry will increase understanding of the association between emerging therapies and patient outcomes for R/R DLBCL, FL, and PMBCL. Study support: Bristol Myers Squibb [Formula presented] Disclosures: Flowers: Amgen: Research Funding;Janssen: Research Funding;Biopharma: Consultancy;Ziopharm: Research Funding;Burroughs Wellcome Fund: Research Funding;Nektar: Research Funding;Karyopharm: Consultancy;Iovance: Research Funding;Allogene: Research Funding;AbbVie: Consultancy, Research Funding;Cellectis: Research Funding;Pfizer: Research Funding;Sanofi: Research Funding;BeiGene: Consultancy;Kite: Research Funding;EMD: Research Funding;Genentech/Roche: Consultancy, Research Funding;Morphosys: Research Funding;Adaptimmune: Research Funding;Novartis: Research Funding;Epizyme, Inc.: Consultancy;Spectrum: Consultancy;Pharmacyclics/Janssen: Consultancy;Acerta: Research Funding;4D: Research Funding;Denovo: Consultancy;Celgene: Consultancy, Research Funding;Guardant: Research Funding;Genmab: Consultancy;Gilead: Consultancy, Research Funding;Bayer: Consultancy, Research Funding;SeaGen: Consultancy;Cancer Prevention and Research Institute of Texas: CPRIT Scholar in Cancer Research: Research Funding;Takeda: Research Funding;National Cancer Institute: Research Funding;TG Therapeutics: Research Funding;Eastern Cooperative Oncology Group: Research Funding;Xencor: Research Funding;Pharmacyclics: Research Funding. Andorsky: Celgene/Bristol Myers Squibb: Research Funding;AbbVie: Consultancy;Celgene/Bristol Myers Squibb: Consultancy;AstraZeneca: Other: served on steering committees;Epizyme: Research Funding;AbbVie: Research Funding. Burke: SeaGen: Consultancy, Speakers Bureau;X4 Pharmaceuticals: Consultancy;Bristol Myers Squibb: Consultancy;Verastem: Consultancy;AstraZeneca: Consultancy;MorphoSys: Consultancy;Adaptive Biotechnologies: Consultancy;Roche/Genentech: Consultancy;Epizyme: Consultancy;Kura: Consultancy;AbbVie: Consultancy;Beigene: Consultancy, Speakers Bureau;Kymera: Consultancy. Cerhan: Genentech: Research Funding;NanoString: Research Funding;Celgene/BMS: Other: Connect Lymphoma Scientific Steering Committee, Research Funding;Regeneron Genetics Center: Other: Research Collaboration. Grinblatt: Astellas Pharma, Inc.: Consultancy;Bristol Myers Squibb: Consultancy;Astra Zeneca: Consultancy;AbbVie: Consultancy. Toomey: Bristol Myers Squibb: Consultancy. Zelenetz: Gilead: Honoraria, Research Funding;Verastem: Honoraria;Novartis: Honoraria;MEI Pharma: Honoraria, Research Funding;SecuraBio: Honoraria;Abbvie: Honoraria, Research Funding;MorphoSys: Honoraria;Pharmacyclics: Honoraria;AstraZeneca: Honoraria;LFR: Other;Genentech/Roche: Honoraria, Research Funding;NCCN: Other;MethylGene: Research Funding;Beigene: Honoraria, Other, Research Funding;BMS/Celgene/JUNO: Honoraria, Other;Amgen: Honoraria;Gilead: Honoraria;Janssen: Honoraria. Sullivan: Bristol Myers Squibb: Current Employment, Current holder of individual stocks in a privately-held company. Flick: Bristol Myers Squibb: Current Employment. Kiselev: Bristol Myers Squibb: Current Employment, Current equity holder in publicly-traded company, Current holder of individual stocks in a privately-held company. Kaplan: Bristol Myers Squibb: Current Employment. Ahn: Bristol Myers Squibb: Current Employment.