Victor M. Orellana-Noia, MD, assistant professor, Department of Hematology and Medical Oncology, Emory University School of Medicine, discusses the treatment of high-risk and vulnerable patients with diffuse large B-cell lymphoma (DLBCL).

Although there are data emerging from many phase 2 and 3 trials in DLBCL and other hematologic malignancies, high-risk and vulnerable patient populations are often excluded from these trials, Orellana-Noia adds. The younger, more fit patients enrolled in these trials generally do not present with central nervous system disease, HIV, prior solid organ transplant, and more, Orellana-Noia explains.

Investigators must make efforts to make clinical trial eligibility more inclusive to evaluate emerging therapies in patients who have higher-risk disease, Orellana-Noia concludes.

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Victor M. Orellana-Noia, MD, discusses the treatment of high-risk and vulnerable patients with diffuse large B-cell lymphoma.

Dr. Orellana-Noia on the Treatment of High-Risk and Vulnerable Patient Populations with DLBCL

Victor M. Orellana-Noia, MD, assistant professor, Department of Hematology and Medical Oncology, Emory University School of Medicine, discusses the patient population of the phase 3 POLARIX trial (NCT03274492) in diffuse large B-cell lymphoma (DLBCL).

The POLARIX trial randomly assigned patients to receive polatuzumab vedotin-piiq (Polivy) plus rituximab (Rituxan), cyclophosphamide, doxorubicin, and prednisone (R-CHP), or rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in patients with previously untreated DLBCL.

Many phase 3 trials evaluating patients with DLBCL have a selection bias, including the POLARIX trial, Orellana-Noia says. The trial did not permit patients with transformed disease from indolent lymphoma or chronic lymphocytic leukemia, Orellana-Noia notes, adding that patients who had a prior solid organ transplant, had an HIV infection, or had central nervous system disease were not included.

Patients who experienced a statistical benefit from polatuzumab vedotin plus R-CHP included older patients who received full-dose, anthracycline-based therapy, plus those with stage III/IV non-bulky disease, Orellana-Noia continues.

Victor M. Orellana-Noia, MD, discusses the patient population of the phase 3 POLARIX trial in diffuse large B-cell lymphoma.


Victor M. Orellana-Noia, MD

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Dr. Orellana-Noia on the Treatment of High-Risk and Vulnerable Patient Populations with DLBCL

Dr. Orellana-Noia on the Patient Population of the POLARIX Trial in DLBCL