How it is administered

Polatuzumab vedotin is administered as an intravenous (IV) infusion. It comes as a sterile, preservative-free, lyophilized powder that is reconstituted and diluted before use. The recommended dose is 1.8 mg/kg given every 21 days for 6 cycles, in combination with other medications depending on the specific treatment regimen.

The infusion is given over 90 minutes for the first dose. If tolerated, subsequent infusions may be administered over 30 minutes. Premedication with an antihistamine and antipyretic is recommended to reduce the risk of infusion-related reactions.

How it works

Polatuzumab vedotin is a targeted therapy known as an antibody-drug conjugate. It combines a monoclonal antibody that specifically binds to CD79b, a protein found on the surface of B cells (including many lymphoma cells), with a potent anti-cancer agent called MMAE (monomethyl auristatin E).

When polatuzumab vedotin attaches to CD79b on the cancer cell, the entire complex is taken into the cell. Inside, the MMAE is released, which disrupts the cell's microtubules—structures needed for cell division. This causes the cancer cell to stop dividing and ultimately die. This targeted approach helps deliver the chemotherapy directly to the cancer cells while minimizing exposure to normal cells.

Who Should take it

Polatuzumab vedotin is indicated for adults with certain types of large B-cell lymphoma:

• For previously untreated diffuse large B-cell lymphoma (DLBCL), not otherwise specified, or high-grade B-cell lymphoma (HGBL), in combination with rituximab, cyclophosphamide, doxorubicin, and prednisone (R-CHP), for patients with an International Prognostic Index score of 2 or greater.

• For relapsed or refractory DLBCL, not otherwise specified, after at least two prior therapies, in combination with bendamustine and rituximab.

Your doctor will determine if polatuzumab vedotin is appropriate for you based on your diagnosis, previous treatments, and overall health.

Who should not take it

There are no absolute contraindications listed for polatuzumab vedotin. However, it should be used with caution in certain situations:

• Patients with pre-existing peripheral neuropathy, as the medication can worsen this condition.
• Patients with severe infections or who are at high risk for infections, since the medication can suppress the immune system.
• Pregnant women, as polatuzumab vedotin can cause harm to an unborn baby. Effective contraception is required during treatment and for a period after the last dose.

Always inform your healthcare provider about your full medical history before starting this medication.

Commonly used with

Polatuzumab vedotin is not used alone for large B-cell lymphoma. It is typically combined with other medications:

• For previously untreated DLBCL or HGBL: rituximab, cyclophosphamide, doxorubicin, and prednisone (R-CHP)
• For relapsed or refractory DLBCL: bendamustine and rituximab

These combinations are designed to maximize the effectiveness of treatment by attacking the lymphoma cells in different ways.

Commonly tested with

Polatuzumab vedotin has been tested in clinical trials in combination with:

• Rituximab, cyclophosphamide, doxorubicin, and prednisone (R-CHP) for newly diagnosed patients
• Bendamustine and rituximab for patients with relapsed or refractory disease

It is also studied with other chemotherapy agents and targeted therapies in various research settings to improve outcomes for patients with B-cell lymphomas.