Posted: Tuesday, February 1, 2022
Hervé Tilly, MD, of Centre Henri-Becquerel and University of Rouen, France, and colleagues evaluated the use of polatuzumab vedotin-piiq—an antibody–drug conjugate targeting CD79b—in combination with rituximab, cyclophosphamide, doxorubicin, and prednisone (R-CHP) among patients with diffuse large B-cell lymphoma (DLBCL). Compared with patients who received R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone), individuals administered polatuzumab vedotin plus R-CHP were found to have a lower risk of relapse, disease progression, and death. These findings from the phase III POLARIX trial were published in The New England Journal of Medicine.
The study enrolled 879 patients with previously untreated, intermediate-risk or high-risk DLBCL. Participants were randomly assigned to receive either polatuzumab vedotin plus R-CHP (n = 440) or R-CHOP (n = 439).
Most patients received all six doses of polatuzumab vedotin plus R-CHP and R-CHOP (91.7% and 88.5%) by the median follow-up of 28.2 months, with 88.0% and 85.9% receiving all eight treatment cycles, respectively. Notably, a higher percentage of patients in the polatuzumab vedotin group (76.7%) survived without disease progression than those in the R-CHOP group (70.2%; P = .02). The overall survival at 2 years did not differ significantly between treatment arms, but event-free survival was significantly improved among those given polatuzumab vedotin plus R-CHP (P = .02).
Safety profiles among both groups appeared to be consistent with previous findings, mostly consisting of adverse events of both any-grade and grade 3 or 4. Neutropenia was the most common grade 3 or 4 adverse event, affecting more patients given R-CHOP (30.8%) than polatuzumab vedotin plus R-CHP (28.3%); febrile neutropenia (13.8% vs. 8.0%) and anemia (12.0% vs. 8.4%) both occurred more frequently among those given polatuzumab vedotin. Discontinuation of treatment due to adverse events was reported in 27 patients given polatuzumab vedotin plus R-CHP and in 29 patients given R-CHOP; dose reductions due to adverse events occurred in 9.2% and 13.0% of individuals, respectively.
Disclosure: For full disclosures of the study authors, visit nejm.org.