Schneider Michael, Nasta Sunita D, Barta Stefan K, Chong Elise A, Svoboda Jakub, Schuster Stephen J, Landsburg Daniel J
Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Clin Lymphoma Myeloma Leuk. 2025 Jan;25(1):45-51. doi: 10.1016/j.clml.2024.08.010. Epub 2024 Sep 6.
Large B cell lymphoma (LBCL) is the most common form of lymphoma. Polatuzumab vedotin (polatuzumab) is an effective therapy for patients diagnosed with LBCL; however, only limited information regarding pathologic features detected by clinical laboratory assays is available to determine which patients are most likely to benefit from polatuzumab based therapies.
We collected data from real world patients with relapsed or refractory LBCL whose tumors underwent next generation sequencing and were treated with polatuzumab based therapy at a single large academic cancer center. Tumor and patient characteristics were analyzed to look for factors that predict response to polatuzumab based therapies.
We identified high grade B cell lymphoma (HGBL) -NOS or MYC/BCL2 histology and presence of MYC rearrangement as factors that predict inferior response to polatuzumab based therapy. Patients with germinal center B cell of origin (GCB COO) LBCL without these factors had a high response rate (73%) to polatuzumab based therapy.
In a single center real world retrospective analysis of R/R LBCL patients with available genomic data, polatuzumab based therapy may be less effective in patients with HGBL-NOS or MYC/BCL2 histology and MYC rearrangements, but not in patients with GCB COO LBCL without these features. Routine performance of more comprehensive pathologic analysis of tumors may inform the use of polatuzumab based therapy in patients with LBCL.
大B细胞淋巴瘤（LBCL）是淋巴瘤最常见的形式。泊洛妥珠单抗（polatuzumab）是诊断为LBCL患者的一种有效治疗方法；然而，关于临床实验室检测所发现的病理特征，只有有限的信息可用于确定哪些患者最有可能从基于泊洛妥珠单抗的治疗中获益。
我们收集了来自现实世界中复发或难治性LBCL患者的数据，这些患者的肿瘤进行了二代测序，并在一家大型学术癌症中心接受了基于泊洛妥珠单抗的治疗。分析肿瘤和患者特征，以寻找预测对基于泊洛妥珠单抗治疗反应的因素。
我们确定高级别B细胞淋巴瘤（HGBL）-NOS或MYC/BCL2组织学以及MYC重排的存在是预测对基于泊洛妥珠单抗治疗反应较差的因素。没有这些因素的生发中心B细胞起源（GCB COO）LBCL患者对基于泊洛妥珠单抗的治疗有较高的反应率（73%）。
在一项对具有可用基因组数据的复发/难治性LBCL患者的单中心现实世界回顾性分析中，基于泊洛妥珠单抗的治疗对具有HGBL-NOS或MYC/BCL2组织学及MYC重排的患者可能效果较差，但对没有这些特征的GCB COO LBCL患者并非如此。对肿瘤进行更全面的病理分析的常规操作可能有助于指导LBCL患者使用基于泊洛妥珠单抗的治疗。
