668 | REAL‐WORLD EVIDENCE OF SECOND‐LINE THERAPY IN RELAPSED/REFRACTORY LARGE B CELL LYMPHOMA: SPANISH MULTICENTER GELTAMO STUDY

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Patients and methods: We performed a retrospective multicenter study based on the GELTAMO registry.Pts with R/R LBCL who had received at least 1 line of chemoimmunotherapy (CIT) from 2013 to 2023 were included.Diffuse LBCL NOS, high-grade BCL double/triple hit and NOS, primary mediastinal and transformed follicular lymphoma were included.2L regimens were grouped into intensive CIT, non-intensive, TT � CIT (including Tafasitamab-Lenalidomide and R-Bendamustine-Polatuzumab), CIT for CNS, palliative treatment (PT) and clinical trials.The primary endpoints were progression-free survival (PFS) and overall survival (OS) after 2L depending on patient eligibility for ASCT.Results: Six-hundred and sixty-four pts were included; 57% were considered candidates for ASCT ( m age 56 years); 63% received intensive CIT, 7% TT � CIT, 10% clinical trials and 10% CIT for CNS; 37% of them finally proceeded to ASCT.mPFS and OS were 5.5 (95% CI: 3.9-7.1)and 23.6 (95% CI: 17.4-29.8)months, respectively.PFS was influenced by lymphoma subtype, ECOG, Ann Arbor (AA) stage, LDH, bulky disease (BD), extranodal sites, status at 2L and proceeding to ASCT (p < 0.01).OS was influenced by subtype, ECOG, AA stage, LDH, BD, extranodal sites, CNS involvement, time period, status at 2L, type of 2L and proceeding to ASCT (p < 0.01).Regarding not candidates ( m age 77 years); 39% received non-intensive CIT mostly R-GEMOX, 13% TT � CIT, 15% clinical trials and 18% PT. mPFS and OS were 3.7 (95% CI: 2.6-4.8) and 8.9 (95% CI: 7.1-10.7)months, respectively.PFS and OS were influenced by subtype, ECOG, AA stage, LDH, BD, extranodal sites, status at 2L and type of 2L.Higher PFS and OS were confirmed for patients within clinical trials (p < 0.01).Multivariate analysis for both subgroups is summarized in Table 1.Conclusions: In our series, PrR disease is the variable that was associated with worse PFS for both cohorts.For candidates, response to 2L for proceeding to ASCT was the strongest variable for better PFS and OS.Currently, with CAR-T therapy approved in 2L for eligible pts, for both candidates and not candidates, these results will probably improve, as well as for ineligible pts with the increasing use of TT in the real-world setting and within clinical trials.A real-world comparison of this cohort with a series of pts receiving CAR-T in 2L in Spain is planned.

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