Jing-Zhou Hou, MD, PhD, co-chair of the Hematological Malignancies program, and medical oncologist, hematologist, and clinical instructor at University of Pittsburgh Medical Center Hillman Cancer Center, discusses the use of polatuzumab vedotin (Polivy) in diffuse large B-cell lymphoma (DLBCL).

On June 10, 2019, the FDA approved polatuzumab vedotin for use in patients with relapsed/refractory DLBCL, based on data from small, randomized phase II trials. These trials compared polatuzumab vedotin plus bendamustine and rituximab (BR; Rituxan) versus BR alone. Each arm had 40 patients, and compared with BR alone, polatuzumab vedotin plus BR demonstrated superior rates of objective responses and complete responses, says Hou. Notably, progression-free survival and overall survival was more than doubled with polatuzumab vedotin plus BR compared with BR alone.

This marks an important approval in DLBCL because current upfront therapies—namely R-CHOP and CAR T-cell products&mdash;have only induced complete remission rates of 40%. Approximately half of patients don’t respond to or relapse after CAR T-cell therapy, at which point there are limited options available. This drug, in combination with BR, shows very promising data, says Hou. Furthermore, it is relatively easy to give and comes with manageable toxicities.

Now, the agent is being explored in phase III trials in the frontline setting, for which data are anticipated in a couple of years.

Videos

Dr. Hou on Polatuzumab Vedotin in DLBCL

Jing-Zhou Hou, MD, PhD, co-chair of the Hematological Malignancies program, and medical oncologist, hematologist, and clinical instructor at University of Pittsburgh Medical Center Hillman Cancer Center, discusses the latest updates with CAR T-cell therapy in diffuse large B-cell lymphoma (DLBCL).

At the 2019 ASCO Annual Meeting, updated data from the ZUMA trials with axicabtagene ciloleucel (axi-cel; Yescarta) were presented in the relapsed/refractory setting. At 24 months of follow-up, the complete response (CR) rate is 40% with an objective response rate of over 50%. The overall survival is also improved with this product. Axi-cel was initially approved by the FDA in October 2017 for use in patients with DLBCL. These data support further investigation into additional CAR T-cell products for transplant-ineligible patients, says Hou.

Data from the phase II JULIET trial which evaluated tisagenlecleucel (Kymriah)] were also published. Updated data showed an accordant response rate at 12-months of follow-up; specifically, the CR rate was 40% and the duration of response was relatively durable for those who had a CR.

The third trial, TRANSCEND-NHL-001 trial, is evaluating lisocabtagene maraleucel (JCAR017; liso-cel). The study has just completed accrual for a phase II trial.

Jing-Zhou Hou, MD, PhD

Articles

Dr. Hou on Polatuzumab Vedotin in DLBCL

Dr. Hou on the Latest Updates With CAR T-Cell Therapy in DLBCL