Amaya M L, Jimeno A, Kamdar M
Divisions of Medical Oncology and Hematology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
Drugs Today (Barc). 2020 Apr;56(4):287-294. doi: 10.1358/dot.2020.56.4.3127026.
Diffuse large B-cell lymphoma (DLBCL) is the most common non Hodgkin lymphoma (NHL) in adults, and it accounts for about 30% of adult NHL cases. Newly diagnosed patients are treated with rituximab in combination with anthracycline-containing chemotherapy, but a significant number of patients relapse after initial treatment. New strategies for relapsed lymphomas are in development among which antibody-drug conjugates (ADCs) are currently in clinical trials. Polatuzumab vedotin is a novel ADC which binds to the commonly expressed B-cell antigen CD79b, and it delivers monomethyl auristatin E, a small molecule with anti-tubulin activity. Polatuzumab vedotin in combination with bendamustine and rituximab (BR) has been approved in the U.S. and the E.U. for use in patients with relapsed or refractory DLBCL ineligible for transplant. These approvals were based on a randomized study of patients treated with either polatuzumab vedotin plus BR or BR alone, where complete response was 40% in the polatuzumab vedotin + BR group versus 18% in the BR group. The most common adverse events of this treatment were cytopenias and peripheral neuropathy.
弥漫性大B细胞淋巴瘤（DLBCL）是成人中最常见的非霍奇金淋巴瘤（NHL），约占成人NHL病例的30%。新诊断的患者接受利妥昔单抗联合含蒽环类化疗，但相当数量的患者在初始治疗后复发。复发淋巴瘤的新策略正在研发中，其中抗体药物偶联物（ADC）目前正在进行临床试验。泊洛妥珠单抗维泊妥英是一种新型ADC，它与普遍表达的B细胞抗原CD79b结合，并递送单甲基奥瑞他汀E，一种具有抗微管蛋白活性的小分子。泊洛妥珠单抗维泊妥英联合苯达莫司汀和利妥昔单抗（BR）已在美国和欧盟获批，用于不符合移植条件的复发或难治性DLBCL患者。这些批准基于一项随机研究，该研究将患者分为接受泊洛妥珠单抗维泊妥英加BR治疗组或单独接受BR治疗组，其中泊洛妥珠单抗维泊妥英+BR组的完全缓解率为40%，而BR组为18%。这种治疗最常见的不良事件是血细胞减少和周围神经病变。
