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

  • Nora Liebers
    Department of Medicine V, Heidelberg University Hospital, Heidelberg, Germany;
  • Johannes Duell
    Department of Internal Medicine II, Würzburg University Hospital, University of Würzburg, Würzburg, Germany;
  • Donnacha Fitzgerald
    Department of Medicine V, Heidelberg University Hospital, Heidelberg, Germany;
  • Andrea Kerkhoff
    Department of Medicine A, University Hospital Münster, Münster, Germany;
  • Daniel Noerenberg
    Department of Hematology, Oncology and Tumor Immunology (Campus Virchow-Klinikum), Charité University Medicine, Berlin, Germany;
  • Eva Kaebisch
    Department of Hematology, Oncology and Tumor Immunology (Campus Virchow-Klinikum), Charité University Medicine, Berlin, Germany;
  • Fabian Acker
    Department of Medicine 2, Hematology and Oncology, University Hospital Frankfurt, Frankfurt, Germany;
  • Stephan Fuhrmann
    Department of Hematology, HELIOS Klinikum Berlin-Buch, Berlin, Germany;
  • Corinna Leng
    Department of Hematology, Oncology, and Tumor Immunology (Campus Benjamin Franklin), Charité University Medicine, Berlin, Germany;
  • Manfred Welslau
    MVZ am Klinikum Aschaffenburg, Onkologie und Hämatologie, Aschaffenburg, Germany;
  • Jens Chemnitz
    Gemeinschaftsklinikum Mittelrhein GmbH, Koblenz, Germany;
  • Jan-Moritz Middeke
    University Hospital Dresden, Dresden, Germany;
  • Thomas Weber
    Department of Medicine IV, Hematology and Oncology, University of Halle, Halle, Germany;
  • Udo Holtick
    Department I of Internal Medicine, Medical Faculty and University Hospital, Cologne, University of Cologne, Cologne, Germany;
  • Ralf Trappe
    Department of Hematology and Oncology, DIAKO Ev. Diakonie-Krankenhaus Bremen, Bremen, Germany;
  • Roald Pfannes
    Department of Medicine I, Städtisches Klinikum Dessau, Dessau, Germany;
  • Ruediger Liersch
    Praxis Medical Center, Gemeinschaftspraxis für Hämatologie und Onkologie Münster, Münster, Germany;
  • Christian Spoer
    MVZ am EVK Düsseldorf, Internistische Onkologie und Hämatologie, Düsseldorf, Germany;
  • Stefan Fuxius
    Onkologische Schwerpunktpraxis Heidelberg, Heidelberg, Germany;
  • Niklas Gebauer
    Department of Haematology and Oncology, University Hospital of Schleswig-Holstein, Campus Lübeck, Germany;
  • Léandra Caillé
    Department of Medicine V, Heidelberg University Hospital, Heidelberg, Germany;
  • Thomas Geer
    Diakonie Klinikum Schwäbisch-Hall, Innere Medizin III, Schwäbisch Hall, Germany;
  • Christian Koenecke
    Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany;
  • Ulrich Keller
    Department of Hematology, Oncology, and Tumor Immunology (Campus Benjamin Franklin), Charité University Medicine, Berlin, Germany;
  • Rainer Claus
    Hematology and Oncology, Medical Faculty, University of Augsburg, Augsburg, Germany;
  • Dimitrios Mougiakakos
    Department of Internal Medicine 5, Hematology and Clinical Oncology, Friedrich-Alexander University (FAU) of Erlangen-Nuremberg, Erlangen, Germany;
  • Stephanie Mayer
    Department of Internal Medicine III, University Hospital of Regensburg, Regensburg, Germany;
  • Andreas Huettmann
    Department of Hematology, University Hospital of Essen, Essen, Germany;
  • Christiane Pott
    Second Medical Department, University Hospital Schleswig-Holstein, Campus Kiel, Germany;
  • Arne Trummer
    Department of Hematology and Oncology, Klinikum Braunschweig, Braunschweig, Germany;
  • Gerald Wulf
    Clinic for Hematology and Medical Oncology, University Medicine Göttingen, Germany; and
  • Uta Brunnberg
    Department of Medicine 2, Hematology and Oncology, University Hospital Frankfurt, Frankfurt, Germany;
  • Lars Bullinger
    Department of Hematology, Oncology and Tumor Immunology (Campus Virchow-Klinikum), Charité University Medicine, Berlin, Germany;
  • Georg Hess
    Department of Hematology, Oncology and Pneumology, Johannes Gutenberg-University, Mainz, Germany
  • Carsten Mueller-Tidow
    Department of Medicine V, Heidelberg University Hospital, Heidelberg, Germany;
  • Bertram Glass
    Department of Hematology, HELIOS Klinikum Berlin-Buch, Berlin, Germany;
  • Georg Lenz
    Department of Medicine A, University Hospital Münster, Münster, Germany;
  • Peter Dreger
    Department of Medicine V, Heidelberg University Hospital, Heidelberg, Germany;
  • Sascha Dietrich
    Department of Medicine V, Heidelberg University Hospital, Heidelberg, Germany;

抄録

<jats:p>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 = 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.</jats:p>

収録刊行物

  • Blood Advances

    Blood Advances 5 (13), 2707-2716, 2021-07-01

    American Society of Hematology

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