Open Access

Nora Liebers, Johannes Düll, Donnacha Fitzgerald, Andrea Kerkhoff, Daniel Nörenberg, Eva Käbisch, Fabian Acker, Stephan Fuhrmann, Corinna Leng, Manfred Welslau, Jens Chemnitz, Jan Moritz Middeke, Thomas Weber, Udo Holtick, Ralf Ulrich Trappe, Roald Pfannes, Rüdiger Liersch, Christian Spoer, Stefan Fuxius, Niklas Gebauer, Léandra Caillé, Thomas Geer, Christian Könecke, Ulrich Keller, Rainer Claus, Dimitrios Mougiakakos, Stephanie Mayer, Andreas Hüttmann, Christiane Pott, Arne Trummer, Gerald Wulf, Uta Brunnberg, Lars Bullinger, Georg Heß, Carsten Müller-Tidow, Bertram Glaß, Georg Lenz, Peter Dreger, Sascha Dietrich

• 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.