TOPLINE:

In patients with previously untreated diffuse large B-cell lymphoma (DLBCL), polatuzumab vedotin, rituximab, cyclophosphamide, doxorubicin, and prednisone (Pola-R-CHP) demonstrated sustained progression-free survival benefit over standard therapy at 5 years, with rates of 64.9% vs 59.1%. The expanded analysis shows fewer lymphoma-related deaths with Pola-R-CHP (46 patients) compared with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP; 62 patients), particularly benefiting high-risk subgroups including activated B-cell DLBCL.

METHODOLOGY:

• Researchers conducted the POLARIX study (ClinicalTrials.gov identifier: NCT03274492) comparing Pola-R-CHP vs R-CHOP in patients with previously untreated intermediate- or high-risk DLBCL.
• Analysis included 879 patients in the global population and an additional 121 Chinese patients in an extension cohort, with a median follow-up of 64.1 months.
• Investigators evaluated progression-free survival as the primary endpoint, with overall survival, event-free survival, and competing risk analysis for lymphoma-related vs other causes of death as secondary outcomes.
• Researchers conducted exploratory analyses of high-risk subgroups, including activated B-cell DLBCL, International Prognostic Index score 3-5, and double-hit lymphoma/triple-hit lymphoma biology.

TAKEAWAY:

• In the global intention-to-treat population, Pola-R-CHP showed significant progression-free survival benefit over R-CHOP (hazard ratio [HR], 0.77; 95% CI, 0.62-0.97), achieving 5-year progression-free survival rates of 64.9% (95% CI, 59.8-70.0) vs 59.1% (95% CI, 53.9-64.3).
• Overall survival analysis, while not statistically significant, demonstrated an improved HR of 0.85 (95% CI, 0.63-1.15) at 5 years compared with 0.94 (95% CI, 0.67-1.33) at 2 years.
• Compared with patients receiving R-CHOP, those receiving Pola-R-CHP required 37.8% fewer subsequent therapies, with 25.5% vs 35.3% needing ≥ 1 line of subsequent therapy.
• According to the researchers, favorable outcomes were observed with Pola-R-CHP in high-risk subgroups, particularly in activated B-cell DLBCL, showing improved progression-free survival (HR, 0.38; 95% CI, 0.24-0.59) and overall survival (HR, 0.49; 95% CI, 0.28-0.88).

IN PRACTICE:

“Findings confirm Pola-R-CHP represents a standard of care for frontline treatment of DLBCL,” wrote the authors of the study.

SOURCE:

This study was led by Franck Morschhauser, MD, PhD, University of Lille in Lille, France. It was published online in the Journal of Clinical Oncology.

LIMITATIONS:

According to the authors, interpretation of the subgroup analysis requires caution due to limited sample size and potential imbalances in baseline characteristics. Additionally, long-term safety follow-up was limited to treatment-related serious adverse events as reported by the investigators.

DISCLOSURES:

This study was supported by F. Hoffmann-La Roche Ltd./Genentech, Inc. Morschhauser disclosed having ties with Roche/Genentech, Chugai/Roche, Takeda, Gilead Sciences, Bristol Myers Squibb, AbbVie, Novartis, Genmab, and Modex Therapeutics. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.