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• W2952494869 abstract "Introduction: Patients with diffuse large B-cell lymphoma (DLBCL) and overexpression of both BCL2 and MYC proteins (double-expressor; DE) or translocations of both MYC and BCL2 genes (double-hit; DH) have inferior outcomes. Given heterogeneity of testing across laboratories, we investigated outcomes of DE and DH patients tested in the real world and treated with first-line (1L) standard-of-care immuno-chemotherapy: rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). If outcomes reflect those in large multi-center trials by central testing, local laboratories may provide reliable and rapid diagnosis, and allow faster trial enrollment and treatment. Methods: We identified DLBCL patients treated with 1L R-CHOP in the Flatiron Health electronic health record (EHR)-derived database with BCL2/MYC expression by immunohistochemistry (IHC) and cytogenetic data by fluorescence in situ hybridization (FISH), based on values extracted by Flatiron Health (2011–18). Due to nonstandard reporting, no standard cutoff was used to assign IHC positivity. Univariate Cox proportional-hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS) and time to next treatment (TTNT). Results: Of 483 patients with both BCL2 and MYC expression available, 232 (48%) were DE. Of 688 patients with both BCL2and MYC translocation available, 44 (6%) were DH, similar to prior findings. Inferior OS and TTNT were observed among DH and DE patients, and those with high BCL2 expression and MYC translocation. Inferior TTNT was observed among patients with high MYC expression and BCL2 translocation. Multivariate analyses will be presented. Conclusions: BCL2 expression and MYC translocation had strong prognostic ability in this population. Despite missing data inherent to EHRs, and varied testing methods used in practice, DE and DH patients had worse prognosis than non-DE and non-DH patients, comparable with results from single-center trials. This demonstrates a robustness of BCL2 and MYC biomarkers to identify high-risk 1L DLBCL patients. Improving technical, interpretive, and reporting accuracy would further strengthen confidence in these markers. Acknowledgments: This study was funded by F. Hoffmann-La Roche–Genentech. Third party editorial assistance was provided, funded by F. Hoffmann-La Roche. This abstract has been previously submitted to EHA 2019. Keywords: BCL2; diffuse large B-cell lymphoma (DLBCL); MYC. Disclosures: Downer, M: Employment Leadership Position: Genentech; Stock Ownership: Genentech; Other Remuneration: Travel, Accommodations, expenses: Genentech. Chaudhary, N: Employment Leadership Position: Genentech; Stock Ownership: Genentech. Szafer-Glusman, E: Employment Leadership Position: Genentech; Stock Ownership: Roche. Breuleux, M: Employment Leadership Position: Roche; Stock Ownership: Roche, Gilead. Hsi, E: Employment Leadership Position: Cleveland Clinic; Consultant Advisory Role: Celgene, Jazz, Seattle Genetics; Research Funding: Abbvie, Eli Lilly. Biondo, J: Employment Leadership Position: Genentech; Stock Ownership: Genentech. Bazeos, A: Employment Leadership Position: Roche; Stock Ownership: Roche. Jiang, Y: Employment Leadership Position: Genentech; Stock Ownership: Genentech." @default.
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• W2952494869 date "2019-06-01" @default.
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• W2952494869 title "REAL-WORLD PROGNOSTIC IMPACT OF BCL2 AND MYC EXPRESSION AND TRANSLOCATION AMONG DIFFUSE LARGE B-CELL LYMPHOMA PATIENTS TREATED WITH FIRST-LINE R-CHOP" @default.
• W2952494869 doi "https://doi.org/10.1002/hon.14_2631" @default.
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