Ten-Year Outcomes after CAR T-Cell Therapy for B-Cell Lymphomas
After 10 years one third of the heavily pretreated lymphoma patients who had CAR-T therapy stayed disease free.
Five-Year Outcomes of the POLARIX Study Comparing Pola-R-CHP and R-CHOP in Patients With Diffuse Large B-Cell Lymphoma
Author(s): Franck Morschhauser, MD, PhD1; Gilles Salles, MD, PhD2; Laurie H. Sehn, MD, MPH3; Alex F. Herrera, MD4; Jonathan W. Friedberg, MD5; Marek Trněný, MD6; Georg Lenz, MD7; Jeff P. Sharman, MD8; Charles Herbaux, MD, PhD9; John M. Burke, MD10; Matthew Matasar, MD11; Graham P. Collins, MBBS, DPhil12; Neha Mehta-Shah, MD13; Lucie Oberic, MD14; Adrien Chauchet, MD15; Wojciech Jurczak, MD, PhD16; Yuqin Song, MD17; Antonio Pinto, MD18; Shinya Rai, MD, PhD19; Koji Izutsu, MD, PhD20; Richard Greil, MD21; Larysa Mykhalska, MD22; Juan M. Bergua-Burgués, MD, PhD23; Matthew C. Cheung, MD24; Ho-Jin Shin, MD, PhD25; Greg Hapgood, MD, PhD26; Eduardo Munhoz, MD27; Pau Abrisqueta, MD, PhD28; Jyh-Pyng Gau, MD29; Yanwen Jiang, PhD30; Bruce McCall, MD30; Saibah Chohan, MSc31; Matthew Sugidono, PharmD30; Mark Yan, PhD31; Connie Lee Batlevi, MD, PhD30; Hervé Tilly, MD32; Christopher R. Flowers, MD33;
Source: DOI: 10.1200/JCO-25-00925
Dr. Maen Hussein's Thoughts
Another update demonstrated the superiority of polatuzumab vedotin plus R-CHOP (Pola-R-CHOP) over R-CHOP alone, with improved progression-free survival (PFS) (64% vs 59%). Overall survival (OS) was not statistically significant; however, the hazard ratio was 0.85, with greater benefit observed in high-risk patients.
ABSTRACT
In the POLARIX study (ClinicalTrials.gov identifier: NCT03274492), polatuzumab vedotin plus rituximab, cyclophosphamide, doxorubicin, and prednisone (Pola-R-CHP) showed a significant progression-free survival (PFS) benefit versus rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in patients with previously untreated intermediate- or high-risk diffuse large B-cell lymphoma (DLBCL; median follow-up: 28 months). In this 5-year update, sustained PFS benefits favoring Pola-R-CHP were observed. In the global intention-to-treat population (N = 879; median follow-up: 64.1 months), Pola-R-CHP demonstrated a significant PFS benefit over R-CHOP (hazard ratio [HR], 0.77 [95% CI, 0.62 to 0.97]), with 5-year PFS rates of 64.9% (95% CI, 59.8 to 70.0) and 59.1% (95% CI, 53.9 to 64.3), respectively. Although not statistically significant, overall survival analysis showed a HR of 0.85 (95% CI, 0.63 to 1.15) the 5-year data cut compared with 0.94 (95% CI, 0.67 to 1.33) the 2-year data cut. In the expanded population, 46 and 62 patients had lymphoma-related deaths in the Pola-R-CHP and R-CHOP arms, respectively. Exploratory analyses showed favorable 5-year survival rates with Pola-R-CHP in high-risk subgroups, including activated B-cell DLBCL and International Prognostic Index score 3-5. Long-term tolerability was similar between treatment arms. Findings confirm Pola-R-CHP represents a standard of care for frontline treatment of DLBCL.
Author Affiliations
1University of Lille, Lille, France; 2Memorial Sloan Kettering Cancer Center, New York, NY; 3BC Cancer Centre for Lymphoid Cancer and the University of British Columbia, Vancouver, BC, Canada; 4City of Hope, Duarte, CA; 5Wilmot Cancer Institute, University of Rochester, Rochester, NY; 6Charles University, Prague, Czech Republic; 7University Hospital Münster, Department of Medicine A—Haematology and Oncology, Münster, Germany; 8Willamette Valley Cancer Institute and Research Center, Florence, OR; 9University of Montpellier, Montpellier, France; 10Rocky Mountain Cancer Centers/US Oncology, Aurora, CO; 11Rutgers Cancer Institute, New Brunswick, NJ; 12Oxford University Hospitals NHS Foundation Trust, Oxford, UK; 13Division of Medical Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO; 14Department of Hematology, Cancer University Institute of Toulouse Oncopole, Toulouse, France; 15Department of Hematology, Besançon University Hospital, Besançon, France; 16Maria Skłodowska-Curie National Research Institute of Oncology, Kraków, Poland; 17Peking University Cancer Hospital, Beijing, China; 18Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori-IRCCS-Fondazione ‘G. Pascale’, Naples, Italy; 19Department of Hematology and Rheumatology, Kindai University, Faculty of Medicine, Osaka-Sayama City, Japan; 20National Cancer Center Hospital, Tokyo, Japan; 21Medical Department III, Paracelsus Medical University Salzburg, Salzburg Cancer Research Institute-Center for Clinical Cancer and Immunology Trials, Cancer Cluster Salzburg, Salzburg, Austria; 22Feofaniya Clinical Hospital, Kyiv, Ukraine; 23Servicio de Hematologia y Hemoterapia, Hospital San Pedro de Alcántara, Cáceres, Spain; 24Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; 25Division of Hematology-Oncology, Department of Internal Medicine, Research Institute of Medical Science, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea; 26Princess Alexandra Hospital, University of Queensland, Brisbane, QLD, Australia; 27Hospital Erasto Gaertner, Curitiba, Brazil; 28Department of Hematology, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain; 29Taipei Veterans General Hospital, Taipei, Taiwan; 30Genentech, Inc, South San Francisco, CA; 31Hoffmann-La Roche Ltd, Mississauga, ON, Canada; 32Centre Henri-Becquerel and University of Rouen, Rouen, France; 33M.D. Anderson Cancer Center, Houston, TXRelated Articles
Tafasitamab plus lenalidomide and R-CHOP versus R-CHOP for first-line treatment of patients with high-risk diffuse large B-cell lymphoma (frontMIND): a global, phase 3, randomised, double-blind, placebo-controlled trial
Progression-free survival was improved in the tafa-len-R-CHOP group vs the R-CHOP with 2-year progression-free survival rates of 71·1vs 62·9% toxicity was higher with tafa-len-R-CHOP with a higher rate of fatal treatment-emergent adverse events, but more overall deaths the RCHOP arm. It is early to add Len taf because of toxicity esp with OS survival and deep response data being immature.
Mosunetuzumab Plus Polatuzumab Vedotin in Transplant-Ineligible Refractory/Relapsed Large B-Cell Lymphoma: Primary Results of the Phase III SUNMO Trial
Median progression-free survival (PFS) was significantly longer with mosunetuzumab plus polatuzumab vedotin (Mosun-Pola) than with R-GemOx (11.5 months vs 3.8 months). The overall response rate (ORR) was significantly higher with Mosun-Pola compared with R-GemOx (70% vs 40%; P < .0001), with complete response rates of 51% and 24%, respectively. Cytokine release syndrome (CRS) occurred in fewer than 5% of patients.
Remission Assessment by Circulating Tumor DNA in Large B-Cell Lymphoma
Minimal residual disease (MRD) testing after two cycles of therapy and at the end of treatment predicted 2-year progression-free survival (PFS) (96% in MRD-negative patients vs 67% in MRD-positive patients). MRD status was more predictive of treatment outcomes than radiographic imaging in this patient population.
Brentuximab Vedotin Combination for Relapsed Diffuse Large B-Cell Lymphoma
The ECHELON-3 study showed BV + Len + R is an active and (relatively) tolerable in the rrDLBCL patient group. Interestingly, patients did not have to be CD30+ to see a benefit.