The Post-POLARIX Trial Era: Polatuzumab Vedotin Shifts DLBCL Treatment

On this episode of The HemOnc Pulse, guest Jonathan Friedberg, MD, MMSc, a hematologic oncologist at the University of Rochester Medicine – Wilmot Cancer Institute, chats with host Chadi Nabhan, MD, MBA, FACP, on the subtle but important shift in the treatment landscape of diffuse large B-cell lymphoma (DLBCL) in the post-POLARIX trial era.

The POLARIX trial, which was designed to improve upon the standard R-CHOP regimen for DLBCL treatment, investigated the potential of polatuzumab vedotin. The phase III trial ultimately resulted in the US Food and Drug Administration approving the treatment in previously untreated DLBCL, not otherwise specified, or high-grade B-cell lymphoma. The approval is for patients with an International Prognostic Index (IPI) score of two or greater.

“I think that this was a robustly done randomized placebo-controlled trial that showed a small but clinically significant benefit as far as progression-free survival in patients with IPI score of two and above [in] large B cell lymphoma,” he said.

Dr. Friedberg also explained some lymphoma subsets might need to be treated differently, but polatuzumab vedotin is expanding the DLBCL treatment landscape.

“Double-hit lymphoma, maybe should be treated differently, he said. “I think there are now unique trials for that, but other forms of DLBCL, I would recommend that based on these results, practice should change. ”

He concluded by saying clinicians and researchers look forward to understanding more about how to use the therapy going forward.

“We look forward to a more enhanced understanding as to how we’re going to use this treatment moving forward, ultimately, hopefully in a precision way,” he said.