Polatuzumab Vedotin Plus Rituximab, Gemcitabine, and Oxaliplatin in Relapsed or Refractory Diffuse Large B-Cell Lymphoma

In the randomised phase III POLARGO trial (n = 255), adding polatuzumab vedotin to R-GemOx prolonged overall survival in patients with relapsed or refractory diffuse large B-cell lymphoma who were ineligible for autologous stem-cell transplantation: median 19.5 versus 12.5 months (HR 0.6; 95% CI 0.43 to 0.83; P = .0017) after a median follow-up of 24.6 months. The cost is substantial: fatal adverse events occurred in 12% of patients on the polatuzumab regimen versus 4% on the control arm and were largely driven by infections including COVID-19, while peripheral neuropathy affected 57% versus 29% of patients, mostly grade 1. The most common grade 3/4 events were thrombocytopenia and neutropenia. The authors position the regimen as an additional treatment option in a population with limited choices after first-line failure.