Polatuzumab vedotin plus bendamustine and rituximab in patients with relapsed/refractory diffuse large B‐cell lymphoma in the real world

Vodička, Prokop; Benešová, Kateřina; Janíková, Andrea; Procházka, Vít; Belada, David; Móciková, Heidi; Steinerová, Kateřina; Ďuraš, Juraj; Karban, Josef; Hanáčková, Veronika; Šýkorová, Alice; Obr, Aleš; Trněný, Marek

doi:10.1111/ejh.13784

Cited by 20 publications

(15 citation statements)

References 13 publications

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“…Notable grade 3‐4 toxicities with this regimen were neutropenia 32.5%, infections (22%), and peripheral neuropathy in 3 patients 16,17 . Real world data shows comparable activity with ORRs 33%–60% (CR 14.8%–40%) without new safely concerns 18–23 …”

Section: Approved Agentsmentioning

confidence: 85%

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Novel agents in relapsed/refractory diffuse large B‐cell lymphoma

Goldstein

Advani

2023

Hematological Oncology

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Patients with relapsed or refractory (R/R) diffuse large B‐cell lymphoma (DLBCL), ineligible for or relapsing after autologous stem‐cell transplant or chimeric antigen‐receptor T‐cell therapies have poor outcomes. Several novel agents, polatuzumab vedotin, tafasitamab, loncastuximab tesirine, and selinexor, have been approved and offer new opportunities for this difficult to treat population. Studies are evaluating combination of these agents with chemotherapy and other emerging therapies. Additionally, advances in our understanding of DLBCL biology, genetics, and immune microenvironment have allowed for the identification of new therapeutic targets like Ikaros and Aiolos, IRAK4, MALT1, and CD47 with several agents in ongoing clinical trials. In this chapter we review updated data supporting the use of the approved agents and discuss other emerging novel therapies for patients with R/R DLBCL.

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Section: Approved Agentsmentioning

confidence: 85%

“…without new safely concerns. [18][19][20][21][22][23] Studies have evaluated polatuzumab with salvage chemotherapy.…”

Section: Polatuzumab Vedotinmentioning

confidence: 99%

Novel agents in relapsed/refractory diffuse large B‐cell lymphoma

Goldstein

Advani

2023

Hematological Oncology

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“…Six additional studies did not distinguish clinical outcomes per treatment line, thus only included values over all lines (all L). 11,12,51,52,54,57 For the 2L, six studies were included: n = 3 for R-GemOx, 13,53,56 n = 2 for BR, 13,56 n = 1 for Tafa-L, 17 and n = 1 for pola-BR. 16 Eleven articles were included for the 3L: n = 5 for axi-cel, [46][47][48][49]55 n = 5 for tisacel, 18,46,47,49,55 n = 2 for liso-cel, 20,50 n = 1 for Tafa-L, 17 n = 1 for pola-R, 16 and n = 1 for R-GemOx.…”

Section: Sensitivity Analysesmentioning

confidence: 99%

Cost‐effectiveness analysis of transplant‐ineligible relapsed or refractory diffuse large B‐cell lymphoma treatment options—Experience of the efficiency frontier approach

Kurte,

Siefen,

Jakobs

et al. 2023

European J of Haematology

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ObjectivesThe treatment of relapsed/refractory (R/R) diffuse large B‐cell lymphoma (DLBCL) changed remarkably since the European Medicines Agency‐approved chimeric antigen receptor T‐cell (CAR‐T) therapies (axicabtagene ciloleucel [axi‐cel], lisocabtagene maraleucel [liso‐cel], tisagenlecleucel [tisa‐cel]) for the third‐line onwards (3+L), and targeted therapies (polatuzumab vedotin–bendamustine–rituximab [pola‐BR], tafasitamab–lenalidomide [Tafa‐L]) for the second‐line (2L) onwards. As associated rising treatment costs represent an economic burden, the cost‐effectiveness of transplant‐ineligible R/R DLBCL interventions was assessed from a German healthcare payer's perspective, using the efficiency frontier (EF) approach.MethodsA systematic literature review was performed to determine the clinical benefit concerning median overall survival (OS) of bendamustine–rituximab (BR), rituximab–gemcitabine–oxaliplatin (R‐GemOx), axi‐cel, liso‐cel, tisa‐cel, pola‐BR, and Tafa‐L. First‐year treatment costs (drug and medical services costs) were calculated. Results were merged on two‐dimensional graphs illustrating 2L and 3+L EFs.ResultsSecond‐line EF is formed by BR (median OS 11.49 months, €23 958) and Tafa‐L (45.7, €104 541), 3+L EF is formed by R‐GemOx (12.0, €29 080), Tafa‐L (15.5, €104 541), and axi‐cel (18.69, €308 516). These interventions build the respective cost‐effectiveness thresholds for novel interventions.ConclusionsUsing the EF approach, the currently most cost‐effective interventions (based on cost‐effectiveness ratios) in the indication of R/R DLBCL were identified to guide international reimbursement decisions.

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“… 86 The experimental results were subsequently confirmed by real-world data. 87 The first-line substitution of vincristine by polatuzumab vedotin, ie, Pola-R-CHP vs R-CHOP regimen, was investigated in the POLARIX study and recently published. 88 Patients between 18–80 years of age with IPI ≥2 and PS ECOG ≤2 entered the analysis.…”

Section: Therapy “Agnostic” To Molecular Biologymentioning

confidence: 99%

Diffuse Large B-Cell Lymphoma (DLBCL): Early Patient Management and Emerging Treatment Options

Vodička¹,

Klener²,

Trněný³

2022

OTT

Self Cite

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Diffuse large B-cell lymphoma (DLBCL) represents a curable disease with a 60–70% chance of cure with current R-CHOP chemoimmunotherapy. However, 30–40% of patients are refractory or relapsing. Many attempts failed to improve the outcome of DLBCL patients, including the intensification of R-CHOP regimen, consolidation, or maintenance therapy since the introduction of R-CHOP in 2000. Better understanding of both molecular biology of lymphoma cells and the tumor microenvironment raised the hope for future improvement of DLBCL patients’ survival. Novel molecular findings have initiated clinical trials exploring targeted therapy based on driver genetic alterations with an intent to improve survival of high-risk subsets of patients. But the preliminary results remain ambiguous. The approach “agnostic” to specific molecular alterations of lymphoma cell includes antibody-drug conjugates (especially polatuzumab vedotin), immunotherapy comprising different antibodies with immunomodulatory effect (tafasitamab, lenalidomide), and T-cell engaging therapy (bispecific antibodies, early use of CAR T-cell). This approach could increase the cure rates and change the current therapeutic paradigm. However, better prognostic stratification, smarter designs of clinical trials, modification of endpoints including the use of ctDNA are needed. This review covers the complexity of DLBCL management.

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Polatuzumab vedotin plus bendamustine and rituximab in patients with relapsed/refractory diffuse large B‐cell lymphoma in the real world

Cited by 20 publications

References 13 publications

Novel agents in relapsed/refractory diffuse large B‐cell lymphoma

Novel agents in relapsed/refractory diffuse large B‐cell lymphoma

Cost‐effectiveness analysis of transplant‐ineligible relapsed or refractory diffuse large B‐cell lymphoma treatment options—Experience of the efficiency frontier approach

Diffuse Large B-Cell Lymphoma (DLBCL): Early Patient Management and Emerging Treatment Options

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