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

Media type: E-Article

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

Contributor: Liebers, Nora; Duell, Johannes; Fitzgerald, Donnacha; Kerkhoff, Andrea; Noerenberg, Daniel; Kaebisch, Eva; Acker, Fabian; Fuhrmann, Stephan; Leng, Corinna; Welslau, Manfred; Chemnitz, Jens; Middeke, Jan-Moritz; Weber, Thomas; Holtick, Udo; Trappe, Ralf; Pfannes, Roald; Liersch, Ruediger; Spoer, Christian; Fuxius, Stefan; Gebauer, Niklas; Caillé, Léandra; Geer, Thomas; Koenecke, Christian; Keller, Ulrich; [...]

imprint: American Society of Hematology, 2021

Language: English

DOI: 10.1182/bloodadvances.2020004155

ISSN: 2473-9529; 2473-9537

Keywords: Hematology

Origination:

Footnote:

Description: 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.

Access State: Open Access

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