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Polatuzumab vedotin as a salvage and bridging treatment in relapsed or refractory large B-cell lymphomas

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Item Type:Article
Title:Polatuzumab vedotin as a salvage and bridging treatment in relapsed or refractory large B-cell lymphomas
Creators Name:Liebers, N. and Duell, J. and Fitzgerald, D. and Kerkhoff, A. and Noerenberg, D. and Kaebisch, E. and Acker, F. and Fuhrmann, S. and Leng, C. and Welslau, M. and Chemnitz, J. and Middeke, J.M. and Weber, T. and Holtick, U. and Trappe, R. and Pfannes, R. and Liersch, R. and Spoer, C. and Fuxius, S. and Gebauer, N. and Caillé, L. and Geer, T. and Koenecke, C. and Keller, U. and Claus, R. and Mougiakakos, D. and Mayer, S. and Huettmann, A. and Pott, C. and Trummer, A. and Wulf, G. and Brunnberg, U. and Bullinger, L. and Hess, G. and Mueller-Tidow, C. and Glass, B. and Lenz, G. and Dreger, P. and Dietrich, S.
Abstract:The antibody-drug conjugate polatuzumab vedotin (pola) has recently been approved in combination with bendamustine and rituximab (pola-BR) for patients with refractory or relapsed (r/r) large B-cell lymphoma (LBCL). To investigate the efficacy of pola-BR in a real-world setting, we retrospectively analyzed 105 patients with LBCL who were treated in 26 German centers under the national compassionate use program. Fifty-four patients received pola as a salvage treatment and 51 patients were treated with pola with the intention to bridge to chimeric antigen receptor (CAR) T-cell therapy (n = 41) or allogeneic hematopoietic cell transplantation (n = 10). Notably, patients in the salvage and bridging cohort had received a median of 3 prior treatment lines. In the salvage cohort, the best overall response rate was 48.1%. The 6-month progression-free survival and overall survival (OS) was 27.7% and 49.6%, respectively. In the bridging cohort, 51.2% of patients could be successfully bridged with pola to the intended CAR T-cell therapy. The combination of pola bridging and successful CAR T-cell therapy resulted in a 6-month OS of 77.9% calculated from pola initiation. Pola vedotin-rituximab without a chemotherapy backbone demonstrated encouraging overall response rates up to 40%, highlighting both an appropriate alternative for patients unsuitable for chemotherapy and a new treatment option for bridging before leukapheresis in patients intended for CAR T-cell therapy. Furthermore, 7 of 12 patients with previous failure of CAR T-cell therapy responded to a pola-containing regimen. These findings suggest that pola may serve as effective salvage and bridging treatment of r/r LBCL patients.
Keywords:Clinical Trials and Observations, Lymphoid Neoplasia, B-Cell Lymphomas, Bendamustine, Chemotherapy Regimen, Chimeric Antigen Receptor T-Cell Therapy, Hematopoietic Stem Cell Transplantation, Lymphoma, Rituximab, Leukapheresis, Antibodies, Chimeric Antigen Receptors
Source:Blood Advances
Publisher:American Society of Hematology
Page Range:2707-2716
Date:13 July 2021
Additional Information:Copyright © 2021 by The American Society of Hematology
Official Publication:https://doi.org/10.1182/bloodadvances.2020004155
PubMed:View item in PubMed

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