Polatuzumab vedotin for the treatment of adults with relapsed or refractory diffuse large B-cell lymphoma

Expert Opin Biol Ther. 2021 Jul;21(7):831-839. doi: 10.1080/14712598.2020.1777979. Epub 2020 Jun 15.

Abstract

Introduction: Polatuzumab vedotin is an antibody-drug conjugate comprised of an anti-CD79b monoclonal antibody conjugated to monomethyl auristatin (MMAE), a microtubule-disrupting cytotoxin. CD79b is almost exclusively expressed on normal and malignant B-cells, making it an appealing target for novel therapeutics.

Areas covered: This article reviews the current literature on polatuzumab vedotin, including its pharmacology, as well as summarizing the results of clinical trials in relapsed/refractory diffuse large B-cell lymphoma (DLBCL) as a single agent and in combination with other chemotherapies and chemoimmunotherapies. The current landscape of approved therapies for relapsed and refractory DLBCL, as well as other promising novel approaches, is discussed.

Expert opinion: The recent approval of polatuzumab vedotin in combination with bendamustine and rituximab (BR) offers another option to patients with DLBCL who are not eligible for autologous hematopoietic cell transplant or chimeric antigen receptors (CAR)-T cell therapy. In younger patients and those without serious comorbidities, polatuzumab vedotin-BR may serve as bridging therapy to more intensive therapies with reasonable efficacy and tolerability. Polatuzumab vedotin is currently being studied in a randomized trial in the front line setting in combination with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP).

Keywords: CD79b; Diffuse large B cell lymphoma; antibody-drug conjugate; polatuzumab vedotin.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Immunoconjugates* / therapeutic use
  • Lymphoma, Large B-Cell, Diffuse* / drug therapy

Substances

  • Antibodies, Monoclonal
  • Immunoconjugates
  • polatuzumab vedotin