First-line treatment with polatuzumab vedotin improves efficacy and survival in newly diagnosed patients with advanced diffuse large B-cell lymphoma: a multicentre retrospective analysis

Polatuzumab vedotin (Pola) is an anti-CD79b monoclonal antibody–drug conjugate that has shown remarkable efficacy and safety in diffuse large B-cell lymphoma (DLBCL) patients. Based on the results of the phase III POLARIX trial, it has been approved for first-line treatment of DLBCL. However, real-world studies are limited, particularly those assessing the efficacy differences between Pola-based regimens and traditional chemotherapy. This multicenter retrospective study analyzed clinical data from 64 newly diagnosed patients with advanced-stage, high-risk, or bulky DLBCL. Patients were categorized into the Pola plus chemotherapy (Pola) and traditional chemotherapy groups based on induction therapy. After excluding 6 patients who received fewer than four cycles of chemotherapy, 58 patients remained for efficacy analysis. The objective response rate after four cycles was 100% in the Pola group compared with 74.1% in the traditional chemotherapy group (p = 0.009). After a median follow-up of 13.5 months (range, 11.0–16.0 months), the median overall survival (OS), progression-free survival (PFS), and duration of response (DOR) in the Pola group were significantly longer than those in the traditional chemotherapy group (all p p 60 years with advanced disease, the Pola group had superior OS, PFS, and DOR (all p Pola plus chemotherapy demonstrates superior efficacy and may prolong survival in patients with newly diagnosed advanced or high-risk DLBCL. However, it does not mitigate the unfavorable prognosis in patients with high P53 expression.