Grand Rounds

Polatuzumab Vedotin for the Front-Line Treatment of Diffuse Large B-Cell Lymphoma: A New Standard of Care?

James A. Davis, PharmD, BCOP, Abigail Shockley, PharmD, Amanda Herbst, PA-C, and Lindsey Hendrickson, DNP, APRN, FNP-C

From Medical University of South Carolina, Charleston, South Carolina

Authors’ disclosures of conflicts of interest are found at the end of this article.

Correspondence to: James A. Davis, PharmD, BCOP, Medical University of South Carolina - Hollings Cancer Center, 86 Jonathan Lucas Street, Charleston, SC 29425 E-mail: davisjaa@musc.edu

ABSTRACT

Diffuse large B-cell lymphoma (DLBCL) is the most common type of aggressive non-Hodgkin lymphoma in the US. For nearly 2 decades, standard front-line treatment has consisted of chemoimmunotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). Numerous trials have unsuccessfully attempted to achieve better outcomes in these patients. Recently, the results of the phase III POLARIX trial were published. This study randomized newly diagnosed DLBCL patients to receive polatuzumab vedotin in combination with rituximab, cyclophosphamide, doxorubicin, and prednisone (pola-R-CHP) or standard-of-care R-CHOP. The POLARIX trial demonstrated 2-year progression-free survival of 76.7% for pola-R-CHP compared with 70.2% for R-CHOP with comparable safety profiles between the two arms. Based on these results, a new standard of care may be emerging in patients with DLBCL. This article provides a practical approach to managing a newly diagnosed patient with DLBCL.

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