Jing-Zhou Hou, MD, PhD, co-chair of the Hematological Malignancies program, and medical oncologist, hematologist, and clinical instructor at University of Pittsburgh Medical Center Hillman Cancer Center, discusses the use of polatuzumab vedotin (Polivy) in diffuse large B-cell lymphoma (DLBCL).
On June 10, 2019, the FDA approved polatuzumab vedotin for use in patients with relapsed/refractory DLBCL, based on data from small, randomized phase II trials. These trials compared polatuzumab vedotin plus bendamustine and rituximab (BR; Rituxan) versus BR alone. Each arm had 40 patients, and compared with BR alone, polatuzumab vedotin plus BR demonstrated superior rates of objective responses and complete responses, says Hou. Notably, progression-free survival and overall survival was more than doubled with polatuzumab vedotin plus BR compared with BR alone.
This marks an important approval in DLBCL because current upfront therapies—namely R-CHOP and CAR T-cell products—have only induced complete remission rates of 40%. Approximately half of patients don’t respond to or relapse after CAR T-cell therapy, at which point there are limited options available. This drug, in combination with BR, shows very promising data, says Hou. Furthermore, it is relatively easy to give and comes with manageable toxicities.
Now, the agent is being explored in phase III trials in the frontline setting, for which data are anticipated in a couple of years.