As reported in the Journal of Clinical Oncology by Morschhauser et al, the 5-year findings of the POLARIX trial showed a continued benefit with polatuzumab vedotin plus rituximab, cyclophosphamide, doxorubicin, and prednisone (Pola-R-CHP) vs rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in patients with previously untreated intermediate- or high-risk diffuse large B-cell lymphoma (DLBCL). The initial report from the trial showed a significant progression-free survival benefit with Pola-R-CHP at a median follow-up of 28 months.
Study Details and Findings
In the international trial, 879 patients were randomly assigned to receive Pola-R-CHP (n = 440) or R-CHOP (n = 439). The primary endpoint was progression-free survival. The current report provides 5-year outcomes of the trial.
Median follow-up in the current report was 64.1 months. The Pola-R-CHP group maintained a significant progression-free survival benefit vs the R-CHOP group (hazard ratio [HR] = 0.77, 95% confidence interval [CI] = 0.62–0.97); the progression-free survival rate at 5 years was 64.9% (95% CI = 59.8%–70.0%) vs 59.1% (95% CI = 53.9%–64.3%), respectively.
A numeric benefit for Pola-R-CHP was observed in overall survival (HR = 0.85, 95% CI = 0.63–1.15), with a 5-year overall survival rate of 82.3% (95% CI = 78.7%–85.9%) vs 79.5% (75.7%–83.4%), respectively. The hazard ratio at 2 years was 0.94 (95% CI = 0.67–1.33).
Exploratory analysis showed favorable 5-year overall survival rates with Pola-R-CHP in such high-risk subgroups as patients with activated B-cell DLBCL (84.6% vs 69.9%, HR = 0.49, 95% CI = 0.28–0.88) and those with an International Prognostic Index score of 3 to 5 (79.2% vs 74.7%, HR = 0.81, 95% CI = 0.57–1.15).
The treatment groups exhibited similar long-term tolerability.
The investigators concluded: “Findings confirm Pola-R-CHP represents a standard of care for frontline treatment of DLBCL.”
Christopher R. Flowers, MD, of MD Anderson Cancer Center, Houston, is the corresponding author of the Journal of Clinical Oncology article.
Disclosure: The study was supported by F. Hoffmann–La Roche Ltd/Genentech, Inc. For full disclosures of all study authors, visit ascopubs.org.
