Case Study: Tracking the Evolution of CAR-T and Immunotherapy Practices in DLBCL

In this case study, we explore how APLUSA’s global research framework delivered data-driven clarity in one of the most complex and fast-changing areas of oncology: immunotherapy for Diffuse Large B-Cell Lymphoma (DLBCL).

Background

The introduction of CAR-T cell therapies and bispecific antibodies has transformed the treatment landscape for Diffuse Large B-Cell Lymphoma (DLBCL). As these innovations move into earlier lines of therapy, treatment pathways are becoming increasingly heterogeneous across regions and institutions. 

A global biopharmaceutical company specializing in cell and gene therapies recognized the growing need to understand how these immunotherapies are adopted in real-world practice. Clinical trial data alone could not explain how physicians were redefining eligibility, sequencing, and referral behaviors in the post-CAR-T era. 

Objectives 

The client sought to answer several key questions critical to strategic and clinical decision-making: 

• How does the introduction of CAR-T therapy in second line redefine the standard of care for early relapsed/refractory patients? 
• What are the key differences in prescribing behavior between CAR-T center physicians and referring physicians? 
• How do new indications influence the treatment journey and patient access pathways?

The overarching aim was to move beyond static market data toward strategic clarity, linking physician practice, perception, and patient access into a single, evidence-based view. 

Methods 

To meet these objectives, APLUSA designed a syndicated global tracking program dedicated to DLBCL immunotherapy. 

The study spans 14 countries across Europe, North America, and Asia-Pacific. Real-world data were collected through detailed patient chart reviews completed by hematologists and oncologists actively managing DLBCL. 

Each wave of the tracker captures consistent, high-resolution information on:

• Treatment pathways across multiple lines of therapy 
• Eligibility criteria for CAR-T and transplant candidates 
• Use of bridging therapies prior to CAR-T infusion 
• Brand-specific CAR-T patient profiling 

Collected data feed into APLUSA’s Digital Interactive Dashboard, enabling dynamic visualization, cross-market comparison, and ongoing access for client stakeholders. 

Results 

Longitudinal analysis from multiple tracker waves revealed measurable trends and actionable insights: 

• Increased CAR-T utilization across most key markets, indicating growing physician confidence and expanding infrastructure. 
• Variability in eligibility and referral definitions across centers, revealing differences in access and interpretation that could impact patient care. 
• Distinct prescribing patterns between CAR-T-authorized centers and referring institutions, highlighting the need for targeted education and coordination.

These findings provided the client with a real-time lens on how immunotherapy is integrated into clinical practice and where process improvements could enhance patient access. 

Discussion 

The insights derived from the DLBCL tracker extended beyond descriptive metrics. They informed strategic and operational decisions across the client’s global and regional teams. 

Through continuous monitoring, the client was able to: 

• Refine its competitive positioning based on validated treatment behaviors. 
• Identify unmet needs and growth opportunities by patient segment and geography. 
• Support evidence-based engagement with clinicians, payers, and policymakers using robust, field-validated data. 

Furthermore, the variation in referral and eligibility patterns underscored the importance of education, network optimization, and access planning in ensuring appropriate patient identification and timely treatment.

Conclusion 

The APLUSA DLBCL Immunotherapy Tracker has evolved into an ongoing market observatory, enabling continuous insight into physician sentiment, adoption behavior, and treatment evolution. 

Findings presented at ASH 2024 highlighted that: 

• Understanding how physicians define eligibility is essential for aligning therapy positioning with real-world practice. 
• Continuous tracking of immunotherapy adoption provides the agility needed to navigate rapid innovation and policy change. 
• Insights from large, multi-country physician panels can bridge the gap between clinical advancement and real-world implementation. 

In an era where innovation outpaces visibility, APLUSA empowers biopharma innovators to turn data into direction, transforming complex, fragmented markets into clear, actionable intelligence.

The APLUSA Advantage 

APLUSA partners with leading pharmaceutical and biotechnology companies to decode complex therapeutic ecosystems through syndicated and customized research. Our expertise in immunology, hematology, and oncology enables clients to: 

• Understand evolving treatment behaviors and referral pathways 
• Anticipate therapeutic transitions and market opportunities 
• Translate real-world evidence into strategic and commercial impact 

Contact 

Curious how continuous real-world data can strengthen your strategy? Connect with APLUSA to explore how tailored physician insights can help you navigate the next wave of immunotherapy innovation.