NEW YORK--(BUSINESS WIRE)--COTA, Inc., a leader in real-world data (RWD) and analytics for oncology, and Memorial Sloan Kettering Cancer Center (MSK) today announced that data from two Diffuse Large B-Cell Lymphoma (DLBCL) studies in older patients will be presented at the upcoming 66th American Society of Hematology Annual Meeting (ASH), held December 7-10, 2024, in San Diego and virtually. The joint research explores the implication of treatment urgency and end-of-life care patterns for older DLBCL patients and provides new findings that demonstrate the potential for RWD to improve cancer care plans for an older, often ignored patient demographic.
Diffuse Large B-Cell Lymphoma (DLBCL) is a blood cancer that is commonly diagnosed in the elderly. Though the median age of diagnosis is 66 years old, nearly 30% of DLBCL cases occur in individuals over 75. Despite the disease being considered largely curable with the right chemotherapy in up to 70% of cases, the survival rate drops precipitously with advancing age.
Additionally, only 9% of randomized control trial (RCT) participants are aged 65+, and just 1% are 75+. Individuals with the most aggressive forms of cancer typically require more immediate therapy, thus making clinical trial participation nearly impossible. Typical clinical trial protocol exclusions–such as age, comorbidities, risk, and physical ability–may also prevent many older and less fit individuals from participating in clinical trials. This exclusion of a key patient group from clinical trials means that we lack clear insight into the care and outcomes of older and less fit individuals, especially those with aggressive disease subtypes.
Alternatively, RWD can offer critical insights into treatment patterns for older patient populations and can be used to inform future clinical trial designs. This method may also help shed new light on what we know about how older patients respond to emerging treatments and how best to manage end-of-life care and outcomes.
“Clinical trials have largely excluded the elderly population which has resulted in uncertainty as to the right treatment approaches for this patient population. Additionally, we know that hospice care tends to be underutilized in the United States, especially in cancer patients. Using technologies powered by real-world data, we can bridge this gap to ensure that older adults receive evidence-based care during a critical time in their life,” said C.K. Wang, M.D., chief medical officer at COTA.
Research to be presented by COTA and MSK at ASH found that older adults with DLBCL who initiated treatment immediately after diagnosis (from zero to two weeks after diagnosis) had worse outcomes, as illustrated by their shorter median times to requiring next-line therapy and shorter overall survival rates compared to patients who had a longer interval between diagnosis and first-line therapy. These patients were also more likely to be treated in academic medical centers, had higher ECOG scores, and had certain high-risk clinical features, including bulky or ABC subtype disease. In a second study, the researchers also found that only a minority of older adults with DLBCL had a documented hospice or palliative care referral. The highest referral rate (38%) was experienced by patients over 90 years old, indicating a need for additional research to understand the value of (or lack thereof) care delivered near the end-of-life.
“The incorporation of real-world data to assess outcomes in older patients is an invaluable resource, given their general decreased representation in clinical trials. The data being presented at ASH 2024 regarding the DTI interval (Diagnosis to Treatment Interval) and the utilization of hospice/palliative care referrals can help inform future trials and identifies ongoing gaps in our knowledge/practices,” noted Paul A. Hamlin, MD, Medical Director, David H. Koch Center for Cancer Care, and Attending, Lymphoma Service - Division of Hematologic Malignancies at MSK.
MSK is a global leader in innovative cancer care and research, driving extramural collaborations and strategic initiatives such as MSK MIND to employ AI and RWD to deliver personalized care and ensure that treatments are accessible, inclusive and responsive to community needs. Leveraging the combined power of MSK’s extensive clinical evidence with COTA’s rich RWD from electronic health records, this research highlights the potential for AI and real-world data to enhance the understanding of treatment responses and end-of-life care in older patients.
With over 85% of study data coming from community care sites, these insights provide a view into cancer care as it truly happens across America. The inclusion of community-based data is imperative, as this data reflects the reality of where many patients receive care. This method is intentional, and allows researchers to ensure insights are applicable to all demographics, regardless of care site or inclusion in research studies.
High-quality, representative data, can support cancer researchers and oncologists with more accurate estimates of outcomes, facilitate more effective shared decision making, and transform palliative oncology and end-of-life care with highly personalized care for each patient. The teams are optimistic that their findings will encourage further research and provide oncologists with more robust clinical evidence to treat older patients at each stage of their care.
About COTA, Inc.
Founded by oncologists, COTA is committed to creating a precise, patient-first approach to cancer care using real-world data. The company leverages technology-supported data abstraction methods to make sense of complex, fragmented patient data from the real world. Offering the highest quality oncology real-world data from leading academic and community-based cancer centers and an advanced analytics platform, COTA partners with leading life sciences companies, providers, and payers to ensure that everyone touched by cancer has a clear path to the right care. To learn more about COTA and how to fast-track improvements in cancer care and treatment with comprehensive and diverse real-world data and analytics, visit cotahealthcare.com.
