Dr Saeed on the Use of Pola-R-CHP in Previously Untreated DLBCL

Hayder Saeed, MD, associate member, Malignant Hematology program, Moffitt Cancer Center, discusses key takeaways from his 2024 OncLive® Bridging The Gaps in Hematologic Malignancies meeting presentation on treatment with polatuzumab vedotin-piiq (Polivy) plus rituximab (Rituxan), cyclophosphamide, doxorubicin, and prednisone (pola-R-CHP) in adult patients with previously untreated diffuse large B-cell lymphoma (DLBCL).

Saeed’s presentation is on the topic ‘Pola for Everyone,’ referring to polatuzumab vedotin, an anti-CD79 antibody-drug conjugate. In August 2023, polatuzumab vedotin was approved by the FDA for use with R-CHP therapy for patients with previously untreated DLBCL not otherwise specified or high-grade B-cell lymphoma who have an International Prognostic Index score of 2 or greater. Notably, this regulatory decision was supported by data from the phase 3 POLARIX trial (NCT03274492), wherein the 2-year PFS rate in patients who received pola-R-CHP (n = 440) was 76.7% (95% CI, 72.7%-80.8%). This approval also converted to a regular approval the 2019 accelerated approval of polatuzumab vedotin plus bendamustine and rituximab in patients with relapsed/refractory DLBCL who had received at least 2 prior therapies.

This presentation regarding the use of pola-R-CHP as frontline treatment for patients with DLBCL stemmed from findings from the POLARIX study showing the advantages of substituting vincristine chemotherapy with polatuzumab vedotin in an all R-CHP regimen, he expands. This study was the first phase 3 trial to demonstrate benefits with pola-R-CHP in this patient cohort and sparked considerable debate because its data sparked a significant shift in treatment standards after many years, Saeed states. In the presentation, Saeed will delve deeper into the trial, its outcomes, and how these outcomes may guide future patient care.

It’s crucial to grasp that the study’s primary outcomes and findings from subgroup analyses do not necessarily dictate treatment for all newly diagnosed patients with DLBCL, he continues. Understanding the role of subgroup analyses and applying the primary outcomes to all eligible patients is vital for optimal disease management, Saeed concludes.