Pola-R-CHP Regimen as First-Line Therapy for Diffuse Large B-Cell Lymphoma: A Retrospective Study of Real-World Clinical Practice
DOI:
https://doi.org/10.21320/2500-2139-2026-19-3-241-252BACKGROUND. For more than 20 years, the standard first-line therapy for diffuse large B-cell lymphoma (DLBCL) has been the R-CHOP regimen. However, about 30–40 % of patients experience relapsed/refractory disease. In the randomized POLARIX study, polatuzumab vedotin-based regimen (Pola-R-CHP) demonstrated a significant progression-free survival advantage over the standard R-CHOP. Yet, the evidence on the use of Pola-R-CHP in the real-world clinical practice in the Russian Federation is currently missing.
AIM. To assess the efficacy and safety of the Pola-R-CHP regimen in patients with newly diagnosed DLBCL in a real-world setting in the Russian Federation.
MATERIALS & METHODS. The multi-center retrospective study enrolled the data from 84 patients (48 men and 36 women) with immunomorphologically verified DLBCL diagnosis treated with polatuzumab vedotin-based first line therapy at 30 medical institutions of the Russian Federation in the period of 2022–2026. The median age of patients was 63 years (range 22–87 years). In 88 % of patients, DLBCL grade 3–4 was reported, 86 % belonged to a high-risk (IPI ≥ 3) group. The primary endpoint was complete response (CR) and overall response (OR) rate after 6 therapy cycles. Secondary endpoints included overall survival (OS), progression-free survival (PFS), metabolic response reported by PET/CT, and the analysis of safety profile.
RESULTS. Full treatment was completed by 68 (81 %) out of 84 patients. After treatment, CR was 80.9 % and OR was 95.0 %. By PET/CT, complete metabolic response was achieved in 47/60 (78 %) patients. The median follow-up was 15.5 months. Neither median PFS nor median OS were achieved; the 2-year PFS was 82.5 % and the 2-year OS was 85.0 %. Most common adverse events (AEs) of any grade were neutropenia (67 %), leukopenia (55 %), anemia (35 %), and febrile neutropenia (14 %). AEs ≥ grade 3 were reported in 31 % of patients.
CONCLUSION. In the real-world clinical practice in the Russian Federation, the Pola-R-CHP regimen showed high efficacy and favorable safety profile in the first-line therapy for DLBCL, also in the population of high-progression-risk patients. The results of the study are consistent with international data and prove the feasibility of risk-adapted treatment for DLBCL.
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Keywords:
diffuse large B-cell lymphoma, Pola-R-CHP, polatuzumab vedotin, first-line therapy, efficacy, safety, real-world clinical practice
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