Polatuzumab vedotin combined with R-ICE as second-line therapy gives favourable results against R/R diffuse large B-cell lymphoma

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Published: 12 Dec 2022
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Dr Matthew Matasar - Rutgers Cancer Institute, New Brunswick, USA

Dr Matthew Matasar speaks to ecancer as part of ASH 2022 about a study he was involved in that looked at polatuzumab vedotin combined with R-ICE as second-line therapy in relapsed/refractory diffuse large B-cell lymphoma.

He reports favourable results with an overall response rate of around 90% and a complete response rate of around 60%.

Dr Matasar notes that the toxicities were not that dissimilar from R-ICE alone.

I’ll be speaking today about our work studying the combination of polatuzumab vedotin in combination with R-ICE chemoimmunotherapy as a treatment for patients with relapsed or refractory diffuse large B-cell lymphoma. This was a multi-centre, single arm phase II study evaluating whether the addition of polatuzumab vedotin to the standard of care platinum based platform of R-ICE could lead to improved outcomes in patients with relapsed or refractory large B-cell lymphoma. We know that R-ICE remains the standard of care for patients with later relapsing large B-cell lymphoma, but, at the time that this study was initiated, R-ICE was standard of care, both for early relapsing and refractory, as well as for later relapsing patients, and all such patients were eligible.

Our results are indeed favourable, we have an overall response rate of approximately 90%, and a complete response rate of approximately 60% in a relatively high-risk patient population, including 40% of treated patients having had primary refractory disease. Encouragingly, the toxicity of the combination did not seem dissimilar to that which we would expect from R-ICE alone. There was no significant increase in neurotoxicity; the neuropathy that was seen was largely grade 1 and reversible. Obviously we need longer follow-up for these patients to see how they did post-transplant, but obviously these are encouraging results.

To briefly describe how the treatment is administered, we administer two or three cycles of polatuzumab plus R-ICE for patients in the second-line setting. Patients who demonstrated chemotherapy sensitive disease, they would go on to receive a standard of care auto-transplant, and then complete whatever doses of polatuzumab vedotin they’re owed, so to speak, with an intention of completing six doses of polatuzumab velotin in total, which we believe is the appropriate dose number to limit neurotoxicity. We look forward to sharing these data in more granular detail at ASH, thank you for your interest.