Song Yuqin, Zhang Qingyuan, Cai Qingqing, Song Yongping, Zhang Liling, He Pengcheng, Wang Li, Hirata Jamie, Musick Lisa, Deng Rong, Liu Wenxin, Wang Xin, Zhu Jun
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, China.
Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China.
J Cancer Res Ther. 2024 Dec 1;20(7):2133-2140. doi: 10.4103/jcrt.jcrt_269_24. Epub 2025 Jan 10.
Patients with transplant-ineligible relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL) have limited treatment options and poor outcomes.
This phase III study (NCT04236141) evaluated the efficacy and safety of polatuzumab vedotin plus bendamustine and rituximab (Pola+BR) versus BR in Chinese patients with transplant-ineligible R/R DLBCL to support regulatory submission in China. Patients were randomized 2:1 to receive Pola+BR or placebo+BR. The primary endpoint was complete response (CR) at the end of treatment (EOT) by positron emission tomography-computed tomography.
Overall, 42 patients were analyzed (Pola+BR, n = 28; placebo+BR, n = 14). At data cutoff (July 12, 2021; median follow-up: 7.5 months), CR at EOT was 25.0% (7/28) with Pola+BR and 14.3% (2/14) with placebo+BR, 10.7% difference [95% confidence interval (CI): -19.0, 40.4]. The median investigator-assessed progression-free survival was 4.6 (95%CI: 3.1-6.4) months with Pola+BR and 2.0 (95% CI: 1.9-4.6) months with placebo+BR, with a 50% reduction in risk of progression or death (unstratified hazard ratio: 0.50; 95% CI: 0.24-1.05). The median overall survival was 10.6 [95% CI: 5.5-not evaluable (NE)] and 6.5 (95% CI: 6.0-NE) months, with a 45% reduction in risk of death. The incidence of Grade 3-4 adverse events was similar between Pola+BR (20/27 patients, 74.1%) and placebo+BR arms (11/14 patients, 78.6%).
Efficacy findings were consistent with results of the GO29365 study (NCT02257567); treatment with Pola+BR led to clinically meaningful improvements in response rates in Chinese patients with transplant-ineligible R/R DLBCL with no new safety signals.
不符合移植条件的复发/难治性弥漫性大B细胞淋巴瘤(R/R DLBCL)患者的治疗选择有限,预后较差。
这项III期研究(NCT04236141)评估了泊洛妥珠单抗维达替尼联合苯达莫司汀和利妥昔单抗(Pola+BR)与苯达莫司汀和利妥昔单抗(BR)在中国不符合移植条件的R/R DLBCL患者中的疗效和安全性,以支持在中国的监管申报。患者按2:1随机分组,接受Pola+BR或安慰剂+BR。主要终点是治疗结束时通过正电子发射断层扫描-计算机断层扫描评估的完全缓解(CR)。
总体上,分析了42例患者(Pola+BR组,n = 28;安慰剂+BR组,n = 14)。在数据截止时(2021年7月12日;中位随访时间:7.5个月),Pola+BR组治疗结束时的CR为25.0%(7/28),安慰剂+BR组为14.3%(2/14),差异为10.7%[95%置信区间(CI):-19.0,40.4]。研究者评估的Pola+BR组中位无进展生存期为4.6(95%CI:3.1-6.4)个月,安慰剂+BR组为2.0(95%CI:1.9-4.6)个月,进展或死亡风险降低50%(未分层风险比:0.50;95%CI:0.24-1.05)。中位总生存期分别为10.6[95%CI:5.5-不可评估(NE)]和6.5(95%CI:6.0-NE)个月,死亡风险降低45%。3-4级不良事件的发生率在Pola+BR组(27例患者中的20例,74.1%)和安慰剂+BR组(14例患者中的11例,78.6%)之间相似。
疗效结果与GO29365研究(NCT02257567)的结果一致;Pola+BR治疗使中国不符合移植条件的R/R DLBCL患者的缓解率有临床意义的提高,且无新的安全信号。