Argnani Lisa, Broccoli Alessandro, Pellegrini Cinzia, Fabbri Alberto, Puccini Benedetta, Bruna Riccardo, Tisi Maria Chiara, Masia Francesco, Flenghi Leonardo, Nizzoli Maria Elena, Musso Maurizio, Salerno Marilena, Scalzulli Potito Rosario, Dessi' Daniela, Ferrarini Isacco, Pennese Elsa, Lucchini Elisa, Rossi Francesca Gaia, Minoia Carla, Gherlinzoni Filippo, Musto Pellegrino, Patti Caterina, Stefoni Vittorio, Zinzani Pier Luigi
IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.
Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Italy.
Hemasphere. 2022 Nov 11;6(12):e798. doi: 10.1097/HS9.0000000000000798. eCollection 2022 Dec.
After FDA and EMA approval of the regimen containing polatuzumab vedotin plus rituximab and bendamustine (PolaBR), eligible relapsed/refractory diffuse large B-cell lymphoma (DLBCL) patients in Italy were granted early access through a Named Patient Program. A multicentric observational retrospective study was conducted focusing on the effectiveness and safety of PolaBR in everyday clinical practice. Fifty-five patients were enrolled. There were 26 females (47.3%), 32 patients were primary refractory and 45 (81.8%) resulted refractory to their last therapy. The decision to add or not bendamustine was at physician's discretion. Thirty-six patients underwent PolaBR, and 19 PolaR. The 2 groups did not differ in most of baseline characteristics. The final overall response rate was 32.7% (18.2% complete response rate), with a best response rate of 49.1%. Median disease-free survival was reached at 12 months, median progression-free survival at 4.9 months and median overall survival at 9 months, respectively. Overall, 88 adverse events (AEs) were registered during treatment in 31 patients, 22 of grade ≥3. Eight cases of neuropathy occurred, all of grades 1-2 and all related to polatuzumab. The two groups of treatment did not differ for effectiveness endpoints but presented statistically significant difference in AEs occurrence, especially in hematological AEs, in AEs of grade equal or greater than 3 and in incidence of neuropathy. Our data add useful information on the effectiveness of Pola(B)R in the setting of heavily pretreated DLBCL and may also suggest a better tolerability in absence of bendamustine without compromise of efficacy.
在含有泊洛妥珠单抗维达汀联合利妥昔单抗和苯达莫司汀(PolaBR)的方案获得美国食品药品监督管理局(FDA)和欧洲药品管理局(EMA)批准后,意大利符合条件的复发/难治性弥漫性大B细胞淋巴瘤(DLBCL)患者通过“指定患者计划”获得了早期用药机会。开展了一项多中心观察性回顾性研究,重点关注PolaBR在日常临床实践中的有效性和安全性。共纳入55例患者。其中女性26例(47.3%),32例为原发性难治性患者,45例(81.8%)对其最后一次治疗无效。是否添加苯达莫司汀由医生自行决定。36例患者接受了PolaBR治疗,19例接受了PolaR治疗。两组在大多数基线特征方面无差异。最终总缓解率为32.7%(完全缓解率为18.2%),最佳缓解率为49.1%。无病生存期、无进展生存期和总生存期的中位数分别为12个月、4.9个月和9个月。总体而言,治疗期间31例患者共记录到88起不良事件(AE),其中22起为≥3级。发生了8例神经病变,均为1 - 2级,且均与泊洛妥珠单抗有关。两组治疗在有效性终点方面无差异,但在不良事件的发生方面存在统计学显著差异,尤其是血液学不良事件、≥3级不良事件和神经病变的发生率。我们的数据为Pola(B)R在高度预处理的DLBCL中的有效性提供了有用信息,也可能表明在不使用苯达莫司汀的情况下耐受性更好且不影响疗效。