Multicenter real-world study of efficacy and relapse profiles of Pola-R-CHP versus R-CHOP in previously untreated diffuse large B-cell lymphoma

A multicenter retrospective cohort study in Japan compared the real-world efficacy of polatuzumab vedotin combined with rituximab, cyclophosphamide, doxorubicin and prednisone (Pola-R-CHP) versus the conventional rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in patients with previously untreated diffuse large B-cell lympoma (DLBCL). The Pola-R-CHP group showed superior 1-year progression-free survival compared to the R-CHOP group (86.7% versus 73.5%; p=0.027); however, the 1-year overall survival was similar (92.8% versus 89.6%; p=0.24). Within the Pola-R-CHP group, the Central Nervous System International Prognostic Index effectively stratified the cumulative incidence of CNS relapse of 0%, 2.1%, and 4.5% in the low-, intermediate-, and high-risk groups, respectively (p=0.023). Additionally, the 1-year incidence of nodal relapse was significantly lower in the Pola-R-CHP group than in the R-CHOP group (2.1% versus 10.9%; p=0.013), whereas the incidence of extranodal relapse remained similar (3.8% versus 5.2%; p=0.57). The authors conclude that these findings underscore the clinical efficacy of Pola-R-CHP over R-CHOP in first-line DLBCL treatment (graphical abstract).