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Polatuzumab Vedotin Improves PFS in Previously Untreated DLBCL
A modified regimen of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in which vincristine is replaced with polatuzumab vedotin (pola-R-CHP) yielded lower risk of disease progression, relapse, or death among patients with previously untreated intermediate-risk or high-risk diffuse large B-cell lymphoma (DLBCL).
“DLBCL is typically treated with R-CHOP. However, only 60% of patients are cured with R-CHOP,” wrote lead author Hervé Tilly, MD, professor in hematology, the University of Rouen, France, and coauthors.
The primary end point of the phase 3 trial was progression-free survival (PFS). Secondary end points included overall survival (OS) and safety.
In the double-blind, placebo-controlled, international study, 879 participants were randomized in a 1:1 ratio to receive 6 cycles of either pola-R-CHP (n = 440) or R-CHOP (n = 439), plus 2 cycles of rituximab alone.
After a median follow-up of 28.2 months, PFS in the pola-R-CHP group was 76.7% (95% CI, 72.7 to 80.8) vs 70.2% in those who received R-CHOP (95% CI, 65.8 to 74.6; hazard ratio [HR], 0.73; P = .02).
OS did not differ significantly between the groups. OS was 88.7% (95% CI, 85.7 to 91.6) in the pola-R-CHP group, and 88.6% (95% CI, 85.6 to 91.6) in the R-CHOP group (HR for death, 0.94; 95% CI, 0.65 to 1.37; P =.75).
The safety profile was similar in the two groups.
Source:
Tilly H, Morschhauser F, Sehn L, et al. Polatuzumab Vedotin in Previously Untreated Diffuse Large B-Cell Lymphoma. N Engl J Med. Published online December 14, 2021. doi:10.1056/NEJMoa2115304.
