[Cohort study of efficacy and safety of polatuzumab vedotin combined with immunochemotherapy in patients with relapse/refractory diffuse large B cell lymphoma]

Zhonghua Yi Xue Za Zhi. 2021 Jul 6;101(25):1985-1990. doi: 10.3760/cma.j.cn112137-20201030-02971.
[Article in Chinese]

Abstract

Objective: To investigate the efficacy and tolerability of Polatuzumab vedotin+rituximab±bendamustine (Pola-(B)R) in relapse/refractory diffuse large B cell lymphoma (R/R DLBCL) patients. Methods: The clinical data of 21 patients enrolled in Chinese Pola compassionate use program (CUP) in 4 centers from November 2019 to August 2020 were collected. There were 15 males and 6 females, and the median age was 56 years (ranged 25-76 years). Of the patients, 10 cases received Pola-BR regimen and the other 11 received Pola-R. Their clinical features, regimens, efficacy, and adverse events (AEs) were retrospectively analyzed. Results: Twenty-one patients with at least one efficacy evaluation were included. At data analysis cut-off point (12 Aug. 2020), the best overall response (BOR) rate was 81.0% (17/21) and the complete response (CR) rate was 19.0% (4/21). Kaplan-Meier survival estimation was performed, at a median follow-up of 54 days, three patients (14.3%) had disease progressed, and 18 patients (85.7%) were censored; the median progression-free survival (mPFS) was estimated to be 148 days. The incidence of adverse effects (AEs) of any grade was higher in Pola-BR group than Pola-R group (80.0% vs 63.6%). However, the incidence of grade 3-4 AEs were close in the two groups (30.0% vs 29.3%). The most common hematological toxicities were thrombocytopenia (28.6%, 6/21), neutropenia (28.6%, 6/21) and anemia (14.3%, 3/21), respectively. One patient with pneumonia and 1 patient with hemophagocytic syndrome recovered after symptomatic treatment. No peripheral neuropathy of grade≥2 was observed. Conclusions: The preliminary data suggested that, for heavily treated Chinese R/R DLBCL, the Pola-(B)R regimen still achieves promising efficacy and tolerable safety.

目的: 分析Polatuzumab vedotin(Pola)联合利妥昔单抗±苯达莫司汀[Pola-(B)R]对复发难治性弥漫大B细胞性淋巴瘤(R/R DLBCL)的疗效及安全性。 方法: 回顾分析2019年11月至2020年8月期间中国Pola同情用药项目(CUP)4个肿瘤中心收治的21例患者资料,其中男15例,女6例;中位年龄56(25~76)岁。10例接受Pola-BR治疗,另外11例仅接受Pola-R治疗。分析其临床特征、用药方案、疗效及不良反应发生情况。 结果: 纳入已接受至少一次疗效评估的21例患者,分析截止于2020年8月12日的数据,最佳总体缓解(BOR)率为81.0%(17/21),完全缓解(CR)率为19.0%(4/21)。用Kaplan-Meier方法估算无进展生存期(PFS),中位随访54 d,发生疾病进展3例(14.3%),删失病例数为18(85.7%),预估中位PFS为148 d。Pola-BR组任何等级的不良反应发生率高于Pola-R组(80.0%比63.6%),但两组3~4级不良反应发生率接近(30.0%比29.3%)。最常见的血液学相关不良反应为:血小板减低(28.6%,6/21)、中性粒细胞减低(28.6%,6/21)及贫血(14.3% 3/21)。1例肺感染及1例合并噬血细胞综合征的患者经对症治疗后康复。所有患者未出现≥2级周围神经病变。 结论: 对于既往多线治疗的中国R/R DLBCL患者,Pola-(B)R方案仍能取得满意的疗效,具有可接受的安全性和耐受性。.

MeSH terms

  • Adult
  • Aged
  • Antibodies, Monoclonal
  • Antineoplastic Combined Chemotherapy Protocols* / therapeutic use
  • Cohort Studies
  • Female
  • Humans
  • Immunoconjugates
  • Lymphoma, Large B-Cell, Diffuse* / drug therapy
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Retrospective Studies
  • Rituximab / therapeutic use
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Immunoconjugates
  • Rituximab
  • polatuzumab vedotin