Treatment patterns and outcomes for second-line therapy in large B-cell lymphoma: results from the LEO CReWE study
Abstract Treatment strategies for relapsed/refractory large B-cell lymphoma (R/R LBCL) have evolved rapidly, yet relationships between therapy selection and outcomes remain poorly defined. The LEO CReWE study evaluated disease characteristics, patterns of care, and outcomes in 1504 patients with R/R LBCL from 2002 to 2022. Of these, 64% received chemoimmunotherapy at second-line (2L). Autologous stem cell transplant (ASCT) and/or chimeric antigen receptor T-cell therapy (CAR-T) were planned at 2L for 984 patients (65%), with 471 (31%) ultimately receiving ASCT and 94 (6%) receiving CAR-T. Complete response (CR) rates at 2L ranged from 24% for lenalidomide-based regimens to 49% for CAR-T; salvage chemotherapy achieved a 44% CR rate overall and 60% among patients who eventually underwent ASCT. Median event-free and overall survival from 2L were 4.3 months and 18.3 months, respectively; survival improved in eras during which CAR-T was available. Patients intended for but unable to receive ASCT or CAR-T experienced poor outcomes comparable to those never intended for curative therapy at 2L. The LEO CReWE study represents the first large-scale depiction of 2L treatment patterns and outcomes for LBCL in the modern era, inclusive of all treatment approaches, and underscores the ongoing need for more effective therapies despite the advent of CAR-T.
Authors
- Thomas Matthew Habermann (ORCID: https://orcid.org/0000-0003-3532-9132)
- Loretta J. Nastoupil (ORCID: https://orcid.org/0000-0001-6071-8610)
- Connie Lee Batlevi (ORCID: https://orcid.org/0000-0002-9036-9463)
- Izidore S. Lossos (ORCID: https://orcid.org/0000-0002-9346-9013)
- Dai Chihara (ORCID: https://orcid.org/0000-0002-1153-2294)
- Eric Mou (ORCID: https://orcid.org/0000-0002-9865-4517)
- Matthew J. Maurer (ORCID: https://orcid.org/0000-0002-1867-0526)
- Grzegorz S. Nowakowski (ORCID: https://orcid.org/0000-0002-6955-9393)
- Ashwini Shewade
- Arushi Khurana (ORCID: https://orcid.org/0000-0001-5645-0949)
- James R. Cerhan (ORCID: https://orcid.org/0000-0002-7482-178X)
- Christopher R. Flowers (ORCID: https://orcid.org/0000-0002-9524-3990)
- Jean Louise Koff (ORCID: https://orcid.org/0000-0003-4414-0489)
- Samuel Yamshon (ORCID: https://orcid.org/0000-0002-4616-8568)
- Tanner W. Reicks
- Umar Farooq (ORCID: https://orcid.org/0000-0001-7891-9891)
- Yucai Wang (ORCID: https://orcid.org/0000-0002-1576-8341)
- Carla Casulo (ORCID: https://orcid.org/0000-0001-9993-5065)
- Melissa C. Larson (ORCID: https://orcid.org/0000-0002-5430-8161)
- Andrea Lo‐Rossi
- Peter Martin
- Anthony Masaquel
- Amy Ayers
- Yong Mun
- Dilan Patel
- Jonathon B. Cohen
Institutions
- University of Iowa (US)
- The University of Texas MD Anderson Cancer Center (US)
- Emory University (US)
- Washington University in St. Louis (US)
- Cornell University (US)
- Mayo Clinic in Arizona (US)
- Mayo Clinic in Florida (US)
- Sylvester Comprehensive Cancer Center (US)
- Weill Cornell Medicine (US)
- University of Rochester (US)
- New York University (US)
Publication Details
- Journal
- Blood Cancer Journal
- Published
- 2026-07-23
- DOI
- https://doi.org/10.1038/s41408-026-01563-2
- Primary Topic
- Lymphoma Diagnosis and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- F. Hoffmann-La Roche
- National Institutes of Health
- Genentech
- National Cancer Institute