Efficacy of polatuzumab vedotin versus conventional chemotherapy in relapsed or refractory diffuse large B-cell lymphoma.

Relapsed or refractory diffuse large B-cell lymphoma (R/R DLBCL) has a poor prognosis, particularly in patients ineligible for autologous stem cell transplantation or cellular immunotherapy. This study evaluated the effectiveness of polatuzumab vedotin combined with rituximab and bendamustine (PBR) therapy in comparison to conventional chemotherapy in patients with R/R DLBCL. Of 86 patients with first relapse or primary refractory DLBCL, 32 received PBR in any subsequent line, while 54 received conventional chemotherapy alone. For comparison, 32 baseline-matched patients were selected from these 54 and defined as the conventional chemotherapy group. The median overall survival (OS) for all patients was 17.3 months (range, 1.5-85.7 months), with the PBR-treated group showing significantly improved outcomes (median OS 19.7 vs. 15.8 months, P = 0.025). Univariate and multivariate analyses identified PBR as a favorable prognostic factor for OS. In the second-line setting, 41.2% of patients who received PBR were ≥ 80 years, compared with just 11.1% of those who received salvage regimens. Despite this older age distribution, the PBR group showed a trend toward favorable progression-free survival. These results suggest that PBR therapy is more effective and tolerable than conventional chemotherapy in patients with R/R DLBCL.