Pola-R-CHP performed well in first-line Polarix trial-ineligible and IPI 0-1 DLBCL patients : Article type: research.

Polatuzumab vedotin, rituximab, cyclophosphamide, doxorubicin, and prednisone (Pola-R-CHP) improved progression-free survival (PFS) of diffuse large B-cell lymphoma (DLBCL) in Polarix study. But little evidence has been provided for patients with lower international prognostic index (IPI) scores or ineligible for clinical trials. We retrospectively enrolled 117 consecutive DLBCL patients aged over 18 years old who received Pola-R-CHP as first-line therapy to investigate efficacy and safety from April 1, 2023, to October 31, 2024. Polatuzumab vedotin was administered 1.8 mg/KG, rituximab 375 mg/m, cyclophosphamide 750 mg/m, doxorubicin 50 mg/m or epirubicin 70 mg/m, all intravenously on Day 1. Prednisone was given 100 mg orally once daily from Day 1 to Day 5. The primary end point was the complete response (CR) rate after 6 cycles. The median age was 56 years old (range: 18-76). Twenty-four (20.5%) patients had an IPI of 0 to 1. Fifty-seven (48.7%) patients were ineligible for Polarix trial. Forty-seven (40.2%) patients received epirubicin instead of doxorubicin. After a median follow-up of 7.1 months (95% CI: 5.967-8.800), CR rate after 6 cycles was 80.6% in all 72 patients who have reached the primary end point, 91.7% in IPI 0-1 subgroup, and 73.5% in Polarix-ineligible subgroup. Lung infection, neutropenia, and leukopenia were the most common grade 3 to 5 adverse events, accounting for 20.5%, 17.9%, and 12.8%. Dose modification of polatuzumab vedotin occurred in 4 patients in Polarix-ineligible group, and 1 in Polarix-eligible group. Pola-R-CHP performed well in first-line Polarix trial-ineligible and IPI 0-1 DLBCL patients with manageable safety.