Adding Polatuzumab Vedotin to R-GemOx Shows Longer Survival in Difficult-to-Treat DLBCL

At the European Hematology Association (EHA) conference, Dr. Matthew Matasar from MSK presented results for the phase III POLARGO clinical trial comparing Pola-R-GemOx to R-GemOx for people with relapsed or refractory diffuse large B-cell lymphoma (DLBCL).

Polatuzumab vedotin (Polivy, Genentech) is an FDA-approved antibody-drug conjugate, it find dividing and cancerous B cells by attaching to the CD79b marker present on all B cell surfaces. 

This study tested whether adding polatuzumab vedotin to rituximab, gemcitabine, and oxaliplatin (also called Pola-R-GemOx) was more effective in improving survival than R-GemOx alone in patients with relapsed/refractory DLBCL. The study included 270 patients who had already tried at least one prior treatment and could not receive a stem cell transplant. 

Adding Polatuzumab Vedotin Had A Positive Impact

Results showed that Pola-R-GemOx significantly improved survival. Patients lived a median of 19.5 months with the combination compared to 12.5 months with R-GemOx alone, which is a 40% reduction in the risk of death. This benefit was consistent even in different subtypes of DLBCL, such as activated B-cell and germinal center B-cell types. 

Besides overall survival, the study looked at how many patients responded to the treatment. This included whether the lymphoma was reduced (objective response rate) or not detected (complete response rate), based on PET-CT scans reviewed by a team of specialists. Pola-R-GemOx improved these response rates compared to R-GemOx alone. 

Side Effects Were Manageable but Required Monitoring

Both treatment groups had similar rates of severe side effects (around 57–58%). However, some side effects were more frequent with Pola-R-GemOx:

• Thrombocytopenia (low platelet levels): 34.4% vs 26.4%
• Infections: 14.1% vs 8.0%
• Peripheral neuropathy (some nerves can cause tingling or numbness) was mostly mild: 57.0% vs 28.8%

These safety findings can help patients understand the potential risks. While Pola-R-GemOx offers longer survival, it may also increase the likelihood of side effects.  If you have concerns about how these side effects can be managed with your doctor, please contact your DLBCL specialist. 

Who May Benefit the Most From Pola-R-GemOx?

This therapy could be an option for patients with relapsed/refractory DLBCL who are not eligible for stem cell transplant and have not previously received polatuzumab vedotin. 

Final Thoughts

This new combination offers a new treatment approach for a population with limited options. Patients should discuss with their healthcare team whether this treatment fits their needs based on prior therapies, current health status, and personal goals. While more side effects may occur, Pola-R-GemOx has shown meaningful benefits in extending survival and increasing response to therapy.

Stay tuned for more conference coverage updates with the HealthTree News Site! 

READ MORE NEWS 

Source: 

• POLATUZUMAB VEDOTIN, RITUXIMAB, GEMCITABINE AND OXALIPLATIN (POLA-R-GEMOX) FOR RELAPSED/REFRACTORY (R/R) DIFFUSE LARGE B-CELL LYMPHOMA (DLBCL): RESULTS FROM THE RANDOMIZED PHASE III POLARGO TRIAL