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

  • 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.
Author:Nora LiebersGND, Johannes DüllGND, Donnacha FitzgeraldORCiD, Andrea KerkhoffGND, Daniel NörenbergGND, Eva KäbischORCiDGND, Fabian AckerORCiDGND, Stephan FuhrmannORCiDGND, Corinna LengGND, Manfred WelslauGND, Jens ChemnitzGND, Jan Moritz MiddekeGND, Thomas WeberORCiDGND, Udo HoltickGND, Ralf Ulrich TrappeORCiDGND, Roald Pfannes, Rüdiger LierschGND, Christian SpoerGND, Stefan FuxiusGND, Niklas Gebauer, Léandra CailléGND, Thomas Geer, Christian KöneckeORCiDGND, Ulrich KellerORCiDGND, Rainer ClausORCiDGND, Dimitrios MougiakakosGND, Stephanie MayerGND, Andreas HüttmannORCiDGND, Christiane PottGND, Arne TrummerGND, Gerald WulfGND, Uta BrunnbergGND, Lars BullingerORCiDGND, Georg HeßGND, Carsten Müller-TidowORCiDGND, Bertram GlaßGND, Georg LenzGND, Peter DregerORCiDGND, Sascha DietrichORCiDGND
Parent Title (English):Blood advances
Publisher:American Society of Hematology
Place of publication:Washington, DC
Document Type:Article
Date of Publication (online):2021/07/01
Date of first Publication:2021/07/01
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2023/05/25
Tag:Clinical Trials and Observations; Lymphoid Neoplasia; antibodies; b-cell lymphomas; bendamustine; chemotherapy regimen; chimeric antigen receptor t-cell therapy; chimeric antigen receptors; hematopoietic stem cell transplantation; leukapheresis; lymphoma; rituximab
Page Number:10
First Page:2707
Last Page:2716
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - CC BY-NC-ND - Namensnennung - Nicht kommerziell - Keine Bearbeitungen 4.0 International