Polatuzumab vedotin as a salvage and bridging treatment in relapsed or refractory large B-cell lymphomas

Liebers N, Duell J, Fitzgerald D, Kerkhoff A, Noerenberg D, Kaebisch E, Acker F, Fuhrmann S, Leng C, Welslau M, Chemnitz J, Middeke JM, Weber T, Holtick U, Trappe R, Pfannes R, Liersch R, Spoer C, Fuxius S, Gebauer N, Caille L, Geer T, Koenecke C, Keller U, Claus R, Mougiakakos D, Mayer S, Huettmann A, Pott C, Trummer A, Wulf G, Brunnberg U, Bullinger L, Hess G, Mueller-Tidow C, Glass B, Lenz G, Dreger P, Dietrich S (2021)

Publication Type: Journal article

Publication year: 2021

Journal

Book Volume: 5

Pages Range: 2707-2716

Journal Issue: 13

DOI: 10.1182/bloodadvances.2020004155

Abstract

The antibody-drug conjugate polatuzumab vedotin (pola) has recently been approved in combination with bendamustine and rituximab (pola-BR) for patients with refractory or relapsed (r/r) large B-cell lymphoma (LBCL). To investigate the efficacy of pola-BR in a real-world setting, we retrospectively analyzed 105 patients with LBCL who were treated in 26 German centers under the national compassionate use program. Fifty-four patients received pola as a salvage treatment and 51 patients were treated with pola with the intention to bridge to chimeric antigen receptor (CAR) T-cell therapy (n 5 41) or allogeneic hematopoietic cell transplantation (n = 10). Notably, patients in the salvage and bridging cohort had received a median of 3 prior treatment lines. In the salvage cohort, the best overall response rate was 48.1%. The 6-month progression-free survival and overall survival (OS) was 27.7% and 49.6%, respectively. In the bridging cohort, 51.2% of patients could be successfully bridged with pola to the intended CAR T-cell therapy. The combination of pola bridging and successful CAR T-cell therapy resulted in a 6-month OS of 77.9% calculated from pola initiation. Pola vedotin-rituximab without a chemotherapy backbone demonstrated encouraging overall response rates up to 40%, highlighting both an appropriate alternative for patients unsuitable for chemotherapy and a new treatment option for bridging before leukapheresis in patients intended for CAR T-cell therapy. Furthermore, 7 of 12 patients with previous failure of CAR T-cell therapy responded to a pola-containing regimen. These findings suggest that pola may serve as effective salvage and bridging treatment of r/r LBCL patients.

Authors with CRIS profile

Involved external institutions

HELIOS Kliniken Germany (DE) Universitätsklinikum Münster Germany (DE) Medizinische Hochschule Hannover (MHH) / Hannover Medical School Germany (DE) Charité - Universitätsmedizin Berlin Germany (DE) Universitätsklinikum Frankfurt am Main (KGU) Germany (DE) Universitätsklinikum Göttingen Germany (DE) Städtisches Klinikum Braunschweig Germany (DE) Universitätsklinikum Heidelberg Germany (DE) Martin-Luther-Universität Halle-Wittenberg (MLU) Germany (DE) Gemeinschaftsklinikum Mittelrhein Germany (DE) Universitätsklinikum Carl Gustav Carus Dresden Germany (DE) Städtisches Klinikum Dessau Germany (DE) Klinikum Aschaffenburg Germany (DE) Julius-Maximilians-Universität Würzburg Germany (DE) Universitätsklinikum Schleswig-Holstein (UKSH) Germany (DE) Diakonie-Klinikum Schwäbisch Hall Germany (DE) Universität zu Köln Germany (DE) Universität Augsburg Germany (DE) DIAKO Evangelisches Diakonie-Krankenhaus gGmbH Germany (DE) Johannes Gutenberg-Universität Mainz (JGU) Germany (DE) Universitätsklinikum Regensburg Germany (DE) Universitätsklinikum Essen Germany (DE)

How to cite

APA:

Liebers, N., Duell, J., Fitzgerald, D., Kerkhoff, A., Noerenberg, D., Kaebisch, E.,... Dietrich, S. (2021). Polatuzumab vedotin as a salvage and bridging treatment in relapsed or refractory large B-cell lymphomas. Blood Advances, 5(13), 2707-2716. https://doi.org/10.1182/bloodadvances.2020004155

MLA:

Liebers, Nora, et al. "Polatuzumab vedotin as a salvage and bridging treatment in relapsed or refractory large B-cell lymphomas." Blood Advances 5.13 (2021): 2707-2716.

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