[Polatuzumab vedotin, bendamustine, and rituximab in patients with relapsed/refractory diffuse large B-cell lymphoma, including the outcome as a bridging treatment to CAR-T cell therapy or allogeneic hematopoietic stem cell transplant]

Rinsho Ketsueki. 2023;64(7):586-595. doi: 10.11406/rinketsu.64.586.
[Article in Japanese]

Abstract

Pola-BR (polatuzumab vedotin, bendamustine, and rituximab) therapy received approval for relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL) in Japan in March 2021. There have been few reports on the efficacy and safety of Pola-BR therapy in Japanese clinical practice. A retrospective analysis was performed on twenty-nine patients with R/R DLBCL who received Pola-BR therapy at our institution (intent to cellular immunotherapy cohort: 20 patients, stand-alone treatment cohort: nine patients). The overall response rate was 69.0% (complete response 27.6%). The median progression-free survival was 5.1 months, with a 9.5-month median overall survival. In the intent to cellular immunotherapy cohort, 11 of 19 patients received chimeric antigen receptor T-cell (CAR-T) infusions, and one patient received allogeneic stem cell transplantation. Four patients received Pola-BR therapy, including bendamustine before leukapheresis, and all produced CAR-T products successfully. 3 of the 28 patients experienced grade3 or higher adverse events, and two required treatment discontinuation. Our single institution, a real-world cohort of R/R DLBCL patients showed high efficacy outcomes and a tolerable toxicity profile for Pola-BR therapy, which is comparable to previous studies. More cases are needed to determine its impact on CAR-T therapy and stem cell transplantation.

Keywords: Allogeneic hematopoietic stem cell transplant; Chimeric antigen receptor T-cell therapy; Polatuzumab vedotin; Relapsed/refractory diffuse large B-cell lymphoma.

Publication types

  • English Abstract

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Bendamustine Hydrochloride / therapeutic use
  • Cell- and Tissue-Based Therapy
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Immunoconjugates* / therapeutic use
  • Lymphoma, Large B-Cell, Diffuse* / drug therapy
  • Lymphoma, Non-Hodgkin* / drug therapy
  • Receptors, Chimeric Antigen* / therapeutic use
  • Retrospective Studies
  • Rituximab / therapeutic use

Substances

  • Bendamustine Hydrochloride
  • Immunoconjugates
  • polatuzumab vedotin
  • Receptors, Chimeric Antigen
  • Rituximab