ABCL-615 Third-Line or Beyond Treatment for Patients With Diffuse Large B-Cell Lymphoma: N. Macedonia Experience With Polatuzumab Vedotin–Based Salvage Immunochemotherapy

• Published in: Clinical lymphoma, myeloma and leukemia Vol. 23; p. S443
• Main Authors: Kochoski, Bozhidar, Veljanovska, Aleksandra Pivkova, Stavridis, Irina Anovska
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-09-2023
• Subjects: polatuzumab; R/R DLBCL; salvage; polatuzumab; salvage; R/R DLBCL
• ISSN: 2152-2650; 2152-2669
• DOI: 10.1016/S2152-2650(23)01339-3

Patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) failing two prior lines of therapy or more, have a poor prognosis, with limited treatment options, especially in low or middle-income countries (LMIC), with no access to CAR T cell therapy. The antibody-drug conjugate polatuzumab vedotin targets CD79b, a B-cell receptor component + rituximab, and bendamustine offers only a salvage option for this group of patients.
We conducted a retrospective review of clinical outcomes and prognostic factors in a single-center cohort study of adult (> 18 years) patients who received polatuzumab-based salvage therapy. The regimen used was polatuzumab-bendamustine-rituximab. We aimed to evaluate the efficacy of polatuzumab vedotin-based chemotherapy as third-line or beyond treatment for patients with R/R DLBCL.
We collected data on clinical characteristics, diagnosis, treatment, and outcomes in adult patients with R/R NHL DLBCL, after ≥ 2 prior lines of therapy. Overall, 12 patients, including those with de novo and with transformed DLBCL, were analyzed.
After a median of 4 cycles (range 1-6), Best responses achieved with polatuzumab were a CR in 2 patients (16.6%) and a PR or clinical response in 4 patients (33.3%), resulting in an OR rate of ~ 50%. 5 patients (41,6%) had progressive disease (PD) and one patient was lost. With a median follow-up of 14 months, six patients were alive, five patients died, and one patient was lost to follow-up.
Patients who relapse after standard therapy often develop chemorefractory disease and have a very dismal outcome. Despite several lines of treatment having previously failed, an OR rate of ~ 50% was achieved in the salvage cohort. Patients in our study had a predominance of 3 or more prior treatment lines. Polatuzumab may have a valuable role to play in R/R DLBCL salvage therapy, even in patients following several failed treatment lines. Further studies are required to improve the identification of R/R patients who will likely benefit from polatuzumab treatment.