Sheng Zhixin, Li Dianfang, Chen Bing, Zhao Chunwu, Zhang Wenxing, Ding Baolong, Wang Lida
Department of Hematology, Weifang People's Hospital, Weifang, China.
Department of Neurosurgery, Weifang People's Hospital, Weifang, China.
Ann Hematol. 2023 May;102(5):1011-1017. doi: 10.1007/s00277-023-05161-1. Epub 2023 Mar 22.
Because of lacking of head-to-head comparison among polatuzumab (Pola) vedotin and other novel agents for untreated diffuse large B-cell lymphoma (DLBCL), the optimal option remains undefined. We searched twelve relevant published reports, covering 8376 subjects. Interestingly, the PFS benefit with Pola-R-CHP over other regimens was found prominently in those B-cell-like type (ABC-type) patients. For those ABC-type patients, the PFS advantage with Pola-R-CHP was statistically significant, when compared to R-CHOP+Bort (HR: 0.52, P=0.02), R-CHOP+Ibru (HR: 0.43, P=0.001), R-CHOP+Lena (HR: 0.51, P=0.009), G-CHOP (HR: 0.46, P=0.008), and R-CHOP (HR: 0.40, P<0.001). Meanwhile, for those germinal center B-cell-like (GCB) type patients, no PFS advantage with Pola-R-CHP was found when compared to R-CHOP+Bort (HR: 1.18, P=0.46), R-CHOP+Lena (HR: 1.21, P=0.45), G-CHOP (HR: 1.39, P=0.14), R-CHOP-14 (HR: 0.94, P=0.82), and R-CHOP (HR: 1.00, P=1). The PFS advantage with Pola-R-CHP over other regimens might be confined to those patients of ABC-type DLBCL.
由于缺乏泊洛妥珠单抗（Pola）维泊妥珠单抗与其他用于治疗初治弥漫性大B细胞淋巴瘤（DLBCL）的新型药物的头对头比较，最佳选择仍不明确。我们检索了12篇相关发表报告，涵盖8376名受试者。有趣的是，在那些B细胞样型（ABC型）患者中，Pola-R-CHP相较于其他方案的无进展生存期（PFS）获益尤为显著。对于那些ABC型患者，与R-CHOP+硼替佐米（HR：0.52，P=0.02）、R-CHOP+伊布替尼（HR：0.43，P=0.001）、R-CHOP+来那度胺（HR：0.51，P=0.009）、G-CHOP（HR：0.46，P=0.008）和R-CHOP（HR：0.40，P<0.001）相比，Pola-R-CHP在PFS方面的优势具有统计学意义。同时，对于那些生发中心B细胞样（GCB）型患者，与R-CHOP+硼替佐米（HR：1.18，P=0.46）、R-CHOP+来那度胺（HR：1.21，P=0.45）、G-CHOP（HR：1.39，P=0.14）、R-CHOP-14（HR：0.94，P=0.82）和R-CHOP（HR：1.00，P=1）相比，未发现Pola-R-CHP在PFS方面的优势。Pola-R-CHP相较于其他方案的PFS优势可能仅限于那些ABC型DLBCL患者。
