Polatuzumab Vedotin Plus DA-EPCH-R Infusional Chemo for B-Cell Non-Hodgkin Lymphoma

Results from the POLARIX Trial 

Polatuzumab vedotin plus DA-EPCH-R infusional chemotherapy yielded safe and effective results among patients with aggressive B-cell non-Hodgkin lymphomas, with increased overall survival (OS), overall response (OR), and complete response (CR) rates, according to findings from the POLARIX trial

Dr Ryan C Lynch, MD, Fred Hutchinson Cancer Center, Seattle, Washington, and coauthors stated that it was previously “unknown if [polatuzumab vedotin] can be safely incorporated into intensified regimens (eg. DA-EPOCH-R) typically utilized for the highest risk histologies.” This study aimed to fill this gap in knowledge, with primary endpoints of measuring the safety of polatuzumab vedotin plus DA-EPCH-R infusional chemotherapy, and secondary endpoints including efficacy and correlation with ctDNA levels. 

17 patients with aggressive large B-cell non-Hodgkin lymphoma were evaluated in this open-label prospective clinical trial. All patients were administered 6 cycles of polatuzumab vedotin plus DA-EPCH-R infusional chemotherapy, with polatuzumab vedotin replacing vincristine. 

The results of this study indicate that this regimen met the safety endpoint, with only 3 dose-limiting toxicities observed out of all patients. A total of 5 serious adverse events were observed, including 3 patients with grade 3 febrile neutropenia, 1 with grade 3 colonic perforation in diverticulitis, and 1 with grade 5 sepsis/typhlitis. 

The best OR rate was 100% and the CR rate was 76%. At 12.9 months, the event-free survival rate was 72% and the OS rate was 94%. There were no relapses, and no patients had undetectable ctDNA levels. 

Dr Lynch et al concluded, “Using [polatuzumab vedotin] to replace vincristine in the DA-EPOCH-R regimen met its primary safety endpoint,” adding, “these data support the further evaluation and use of this approach in histologies where the potential benefit of both an intensified regimen and [polatuzumab vedotin] may be desired.”

Source:

Lynch RC, Poh C, Ujjani CS, et al. Polatuzumab vedotin with infusional chemotherapy (Pola-DA-EPCH-R) for untreated aggressive B-cell non-Hodgkin lymphomas. Blood Advances. Published online December 15, 2022. doi:https://doi.org/10.1182/bloodadvances.2022009145