2. Academic Validation
  3. Polatuzumab vedotin as a salvage and bridging treatment in relapsed or refractory large B-cell lymphomas

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

  • Blood Adv. 2021 Jul 13;5(13):2707-2716. doi: 10.1182/bloodadvances.2020004155.
Nora Liebers 1 2,  Johannes Duell 3,  Donnacha Fitzgerald 1 4,  Andrea Kerkhoff 5,  Daniel Noerenberg 6,  Eva Kaebisch 6,  Fabian Acker 7,  Stephan Fuhrmann 8,  Corinna Leng 9,  Manfred Welslau 10,  Jens Chemnitz 11,  Jan-Moritz Middeke 12,  Thomas Weber 13,  Udo Holtick 14,  Ralf Trappe 15,  Roald Pfannes 16,  Ruediger Liersch 17,  Christian Spoer 18,  Stefan Fuxius 19,  Niklas Gebauer 20,  Léandra Caillé 1,  Thomas Geer 21,  Christian Koenecke 22,  Ulrich Keller 9,  Rainer Claus 23,  Dimitrios Mougiakakos 24,  Stephanie Mayer 25,  Andreas Huettmann 26,  Christiane Pott 27,  Arne Trummer 28,  Gerald Wulf 29,  Uta Brunnberg 7,  Lars Bullinger 6,  Georg Hess 30,  Carsten Mueller-Tidow 1 2,  Bertram Glass 8,  Georg Lenz 5,  Peter Dreger 1,  Sascha Dietrich 1 2 4
Affiliations

Affiliations

  • 1 Department of Medicine V, Heidelberg University Hospital, Heidelberg, Germany.
  • 2 National Center for Tumor Diseases Heidelberg, Heidelberg, Germany.
  • 3 Department of Internal Medicine II, Würzburg University Hospital, University of Würzburg, Würzburg, Germany.
  • 4 European Molecular Biology Laboratory, Heidelberg, Germany.
  • 5 Department of Medicine A, University Hospital Münster, Münster, Germany.
  • 6 Department of Hematology, Oncology and Tumor Immunology (Campus Virchow-Klinikum), Charité University Medicine, Berlin, Germany.
  • 7 Department of Medicine 2, Hematology and Oncology, University Hospital Frankfurt, Frankfurt, Germany.
  • 8 Department of Hematology, HELIOS Klinikum Berlin-Buch, Berlin, Germany.
  • 9 Department of Hematology, Oncology, and Tumor Immunology (Campus Benjamin Franklin), Charité University Medicine, Berlin, Germany.
  • 10 MVZ am Klinikum Aschaffenburg, Onkologie und Hämatologie, Aschaffenburg, Germany.
  • 11 Gemeinschaftsklinikum Mittelrhein GmbH, Koblenz, Germany.
  • 12 University Hospital Dresden, Dresden, Germany.
  • 13 Department of Medicine IV, Hematology and Oncology, University of Halle, Halle, Germany.
  • 14 Department I of Internal Medicine, Medical Faculty and University Hospital, Cologne, University of Cologne, Cologne, Germany.
  • 15 Department of Hematology and Oncology, DIAKO Ev. Diakonie-Krankenhaus Bremen, Bremen, Germany.
  • 16 Department of Medicine I, Städtisches Klinikum Dessau, Dessau, Germany.
  • 17 Praxis Medical Center, Gemeinschaftspraxis für Hämatologie und Onkologie Münster, Münster, Germany.
  • 18 MVZ am EVK Düsseldorf, Internistische Onkologie und Hämatologie, Düsseldorf, Germany.
  • 19 Onkologische Schwerpunktpraxis Heidelberg, Heidelberg, Germany.
  • 20 Department of Haematology and Oncology, University Hospital of Schleswig-Holstein, Campus Lübeck, Germany.
  • 21 Diakonie Klinikum Schwäbisch-Hall, Innere Medizin III, Schwäbisch Hall, Germany.
  • 22 Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.
  • 23 Hematology and Oncology, Medical Faculty, University of Augsburg, Augsburg, Germany.
  • 24 Department of Internal Medicine 5, Hematology and Clinical Oncology, Friedrich-Alexander University (FAU) of Erlangen-Nuremberg, Erlangen, Germany.
  • 25 Department of Internal Medicine III, University Hospital of Regensburg, Regensburg, Germany.
  • 26 Department of Hematology, University Hospital of Essen, Essen, Germany.
  • 27 Second Medical Department, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
  • 28 Department of Hematology and Oncology, Klinikum Braunschweig, Braunschweig, Germany.
  • 29 Clinic for Hematology and Medical Oncology, University Medicine Göttingen, Germany; and.
  • 30 Department of Hematology, Oncology and Pneumology, Johannes Gutenberg-University, Mainz, Germany.
PMID: 34196677 DOI: 10.1182/bloodadvances.2020004155
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.

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