Polatuzumab Vedotin Combo Shows Promising Activity in R/R DLBCL

Polatuzumab vedotin has shown promising activity when combined with rituximab and bendamustine in patients with relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL), according to a recent study published in Annals of Hematology (Ann Hematol. 2022 Feb; epub ahead of print).

However, “few studies have described the prognostic factors predicting response,” explained Yu-Wen Wang, Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan, and co-authors.

Thus, Dr Wang and co-authors evaluated the efficacy, safety, and prognostic factors of polatuzumab vedotin-based chemotherapy, including regimens other than rituximab and bendamustine, as third-line or more treatment for patients with R/R DLBCL.

Overall, 40 patients with DLBCL, including 47 with de novo DLBCL and 3 with transformed DLBCL, were enrolled to the study.

The overall response rate (ORR) was 52.5%, with 25% and 27.5% of patients showing a complete response (CR) or partial response (PR), respectively. At a median follow-up of 18.8 months, the median overall survival (OS) was 8.5 months. For patients receiving subsequent hematopoietic stem cell transplantation (HSCT), the OS was 24 months.

“Low/intermediate risk according to the revised International Prognostic Index score at diagnosis and before polatuzumab vedotin treatment predicted better OS. Furthermore, a normal lactate dehydrogenase level and an absolute lymphocyte count/absolute monocyte count ratio > 1.5 were favorable OS prognostic factors,” continued Dr Wang and co-authors.

The most common adverse events (AEs) were cytopenia and febrile neutropenia. Grade 1-3 peripheral neuropathy associated with polatuzumab vedotin was reported in 25% of patients and resolved in most after the treatment ended.

“In summary, we demonstrated that polatuzumab vedotin combined with either rituximab-bendamustine or other intensive chemotherapy is an effective and well-tolerated salvage option for patients with R/R DLBCL. Subsequent HSCT has the potential to further improve survival outcomes in this high-risk population,” concluded Dr Wang et al.—Emily Bader