Polatuzumab Vedotin-Piiq

Salvage chemoimmunotherapy followed by autologous stem cell transplantation (ASCT) remains a standard therapy for relapsed/refractory (r/r) diffuse large B‐cell lymphoma (DLBCL) who relapse > 1 year after frontline treatment. We evaluated the safety and efficacy of polatuzumab vedotin (Pola) combined with R‐ICE salvage chemotherapy, followed by post‐ASCT Pola maintenance, aiming to improve complete response (CR) rates and enhance post‐ASCT outcomes in r/r DLBCL. Notably, the study's accrual period predated the approvals of second‐line CAR T cell therapies. Forty‐one patients were enrolled and received PolaR‐ICE. Adverse effects of the combination were consistent with those observed with Pola and R‐ICE chemotherapy with no new toxicity signals observed and were most commonly hematologic and gastrointestinal. The overall response rate after salvage was 88% with a CR rate of 56%. Twenty‐two patients (56%) went on to receive autologous stem cell transplant and 16 (39%) received Pola consolidation. At a median follow‐up of 25 months (range: 18–21), the 2‐year PFS of all patients treated with PolaR‐ICE ( n  = 41) was 49.9% (95% CI: 31.7–65.7) and 2‐year OS was 75.0% (95% CI: 58.5–85.8). Patients with relapse ≤ 12 months of initial therapy achieved a 2‐year PFS of 36.4% (90% CI: 17.1–56.0) versus 80.0% (95% CI: 40.9–94.6) among patients with relapse ≥ 12 months. Our findings demonstrate that Pola‐RICE is a safe and effective salvage regimen for r/r DLBCL, which can be considered for patients with late relapse or in areas where CAR T access may be limited. Trial Registration:ClinicalTrials.gov identifier: NCT04665765