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波拉珠单抗维地布汀联合苯达莫司汀和利妥昔单抗治疗复发/难治性弥漫性大 B 细胞淋巴瘤:生存数据更新及新扩展队列数据。

Polatuzumab vedotin plus bendamustine and rituximab in relapsed/refractory DLBCL: survival update and new extension cohort data.

机构信息

BC Cancer Centre for Lymphoid Cancer and The University of British Columbia, Vancouver, BC, Canada.

Prince of Wales Hospital and University of New South Wales, Sydney, NSW, Australia.

出版信息

Blood Adv. 2022 Jan 25;6(2):533-543. doi: 10.1182/bloodadvances.2021005794.

Abstract

Polatuzumab vedotin plus bendamustine and rituximab (pola + BR) received regulatory approvals for relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL) based on primary results from the randomized arms of the GO29365 study. After the randomized phase, 106 additional patients received pola + BR in a single-arm extension cohort. We report updated results from the randomized arms and results of the extension cohort. In this phase 1b/2 study, patients with R/R DLBCL who were transplant ineligible received up to six 21-day cycles of pola + BR or BR. The primary end point of the randomized arms was the complete response (CR) rate at end of treatment. Primary objectives of the extension cohort were safety, pharmacokinetic profile, and efficacy of pola + BR. As of 7 July 2020, a total of 192 patients with R/R DLBCL were enrolled in the pola + BR cohort (n = 152 [safety run-in, n = 6; randomized, n = 40; extension cohort, n = 106]) or the BR cohort (n = 40). Significant survival benefit with pola + BR vs BR persisted in the randomized arms (median progression-free survival, 9.2 vs 3.7 months [hazard ratio, 0.39; 95% confidence interval, 0.23-0.66]; median overall survival, 12.4 vs 4.7 months [hazard ratio, 0.42; 95% confidence interval, 0.24-0.72]). In the extension cohort, the independent review committee-assessed objective response rate was 41.5%, and the CR rate was 38.7%; median independent review committee-assessed progression-free survival and overall survival were 6.6 months and 12.5 months, respectively. No new safety signals with pola + BR were identified. Pola + BR is an effective treatment option for patients with R/R DLBCL, with a well-characterized and manageable safety profile. This trial was registered at www.clinicaltrials.gov as #NCT02257567.

摘要

基于 GO29365 研究随机臂的主要结果,泊马度胺联合苯达莫司汀和利妥昔单抗(pola+BR)已获批用于治疗复发/难治性弥漫性大 B 细胞淋巴瘤(R/R DLBCL)。在随机阶段后,106 例患者在单臂扩展队列中接受了 pola+BR 治疗。我们报告了该随机臂的更新结果和扩展队列的结果。在这项 1b/2 期研究中,不适合进行移植的 R/R DLBCL 患者接受最多六个 21 天周期的 pola+BR 或 BR 治疗。随机臂的主要终点是治疗结束时的完全缓解(CR)率。扩展队列的主要目标是评估 pola+BR 的安全性、药代动力学特征和疗效。截至 2020 年 7 月 7 日,共有 192 例 R/R DLBCL 患者入组了 pola+BR 队列(n=152[安全性预试验,n=6;随机分组,n=40;扩展队列,n=106])或 BR 队列(n=40)。在随机分组中,与 BR 相比,pola+BR 仍具有显著的生存获益(无进展生存期的中位数,9.2 个月 vs 3.7 个月[风险比,0.39;95%置信区间,0.23-0.66];总生存期的中位数,12.4 个月 vs 4.7 个月[风险比,0.42;95%置信区间,0.24-0.72])。在扩展队列中,独立审查委员会评估的客观缓解率为 41.5%,CR 率为 38.7%;独立审查委员会评估的无进展生存期和总生存期的中位数分别为 6.6 个月和 12.5 个月。与 pola+BR 相关的新安全性信号未被识别。Pola+BR 是一种有效的 R/R DLBCL 治疗选择,具有明确的、可管理的安全性特征。该试验在 www.clinicaltrials.gov 注册,编号为#NCT02257567。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f328/8791582/a0c030090ee1/advancesADV2021005794absf1.jpg

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