Polatuzumab-Based Regimens Demonstrate Promising Efficacy for R/R DLBCL Compared to Traditional Salvage Therapies
The combination of polatuzumab vedotin, zanubrutinib, and rituximab or obinutuzumab (Pola-ZR/G) showed encouraging clinical activity with a manageable safety profile among patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) compared to data from patients treated with traditional salvage therapies, according to study results published in Cancer Medicine.
Previous research has found polatuzumab vedotin, a CD79b antibody-drug conjugate, demonstrated clinical efficacy among patients with R/R DLBCL patients. Researchers conducted a real-world observational study to determine the efficacy and safety of polatuzumab vedotin and zanubrutinib combined with rituximab or obinutuzumab.
Overall, 22 patients were included, and the median age was 68 years. The median number of lines of prior treatment was 1 (range, 1 to 5). Patients received 6 21-day cycles of polatuzumab vedotin, zanubrutinib, and rituximab (n=11) or polatuzumab vedotin, zanubrutinib, and obinutuzumab (n=11), followed by maintenance therapy with zanubrutinib. Researchers collected data from 73 R/R DLBCL patients who received traditional salvage therapies (TST). After propensity score matching, they were compared for effectiveness and survival outcomes.
After a median follow-up of 16.1 months, the best overall response (BOR) rate for patients treated with polatuzumab vedotin, zanubrutinib, and rituximab was 77.77%. For patients treated with polatuzumab vedotin, zanubrutinib, and obinutuzumab the BOR was 63.6%, among all patients the BOR was 70%. Patients in the rituximab group had a complete response rate of 44.44%, which was only incrementally lower than patients in the obinutuzumab group (45.45%). Median overall survival had not been reached at the time of analysis.
Median progression-free survival (mPFS) was 8.7 months (95% confidence interval [CI], .577 to 16.82) among patients treated with polatuzumab vedotin, zanubrutinib, and rituximab or obinutuzumab, which was longer compared to a matched cohort of 73 R/R DLBCL patients treated with TST.
In terms of safety, infections were more common among patients in the obinutuzumab group (45.45%) than patients in the rituximab group (36.36%). Of these infections, the most common was lung infection, half of which were grade 3.
The researchers concluded, “In conclusion, in a highly refractory high-risk group of patients with R/R DLBCL, Pola-ZR/G has shown promising therapeutic improvement with a manageable safety profile.”
Source:
Zhang Y, Ren Y, Zhuang J, et al. Effectiveness and Safety of Polatuzumab Vedotin Plus an Anti‐CD20 Monoclonal Antibody (Rituximab or Obinutuzumab) and Zanubrutinib in Relapsed/Refractory Diffuse Large B‐Cell Lymphoma. Cancer Medicine. Published online August 19, 2025. doi:10.1002/cam4.71162
