Evaluating the effectiveness and safety of polatuzumab vedotin combined with dose-adjusted EPOCH-R chemotherapy in patients with aggressive B-cell non-Hodgkin lymphoma.

This study evaluated the effectiveness and safety of polatuzumab vedotin (PV; Polivy) combined with dose-adjusted EPOCH-R chemotherapy (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab) in patients with aggressive B-cell non-Hodgkin lymphoma (NHL). The data showed that PV combined with dose-adjusted EPOCH-R chemotherapy was effective with manageable side effects in these patients.

Non-Hodgkin lymphoma (NHL) is a cancer that starts in white blood cells called lymphocytes. These are a part of the body’s immune system. It is mostly diagnosed in older people. The most common treatment for aggressive NHL involves the chemotherapy regimen called R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone). However, 30-40% of patients experience relapse or develop refractory disease. New treatment strategies are needed.

One approach is to add new anti-cancer drugs to the R-CHOP regimen. Previous studies have evaluated combining R-CHOP with targeted therapies. One such combination involves PV. PV is a new monoclonal antibody. This type of treatment binds to cancer cells, leading to cancer cell death. A previous study showed that substituting vincristine (Oncovin) in R-CHOP with PV was safe and effective for patients with large B-cell lymphomas. However, the effectiveness and safety of PV with dose-adjusted EPOCH-R chemotherapy in patients with aggressive B-cell NHL is still unknown.

This study involved 18 patients with aggressive B-cell NHL. All patients received PV plus dose-adjusted EPOCH-R chemotherapy. The average follow-up time was 12.9 months.

After 12 months, 94% of the patients were alive and 72% of the patients were alive without any signs or symptoms of cancer.

Overall, 100% of the patients responded to the treatment. The complete response (complete disappearance of cancer cells) rate was 76%.

The most common serious side effects were low white blood cell counts with fever (17%), inflammation of pouches in the colon (6%), and inflammation of a part of the large intestine (6%).

This study concluded that PV combined with dose-adjusted EPOCH-R chemotherapy was effective with manageable side effects in patients with aggressive B-cell NHL.

The sample size was very small. This study only included patients treated at a single institution in the USA. The patients knew which treatment they were getting.