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<p>The POLARIX trial demonstrated progression-free survival (PFS) benefit with polatuzumab vedotin-based therapy (Pola-R-CHP) over R-CHOP in diffuse large B-cell lymphoma (DLBCL). However, real-world data are limited for populations underrepresented in POLARIX, including patients with limited-stage disease, low international prognostic index (IPI) risk, or aged ≥ 81 years. We compared Pola-R-CHP and R-CHOP efficacy using propensity score matching (82 pairs from 86 to 189 patients, respectively). Patients newly diagnosed with DLBCL treated with Pola-R-CHP showed trends toward improved 2-year PFS overall (75.5% vs. 61.4%, <i>p</i> = 0.065), in limited-stage disease (96.0% vs. 73.8%, <i>p</i> = 0.057), and in low- IPI risk (100% vs. 81.2%, <i>p</i> = 0.11), with significant benefit in non-GCB subtype (76.3% vs. 51.0%, <i>p</i> = 0.013) compared to those with R-CHOP. No difference was detected between patients treated with Pola-R-CHP and R-CHOP aged ≥ 81 years (<i>p</i> = 0.43). In patients treated with Pola-R-CHP, age ≥ 81 years was an independent adverse factor for overall survival (OS) (HR 5.44, 95% CI 1.05–32.26, <i>p</i> = 0.044). This real-world study is consistent with POLARIX findings in non-GCB DLBCL and suggests potential benefits in limited-stage or low-IPI patients, though validation is needed. Results support Pola-R-CHP across diverse populations, with careful selection for treatment warranted in patients aged ≥ 81 years.</p>

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Comparison between Pola-R-CHP and R-CHOP regimens in patients newly diagnosed with diffuse large B-cell lymphoma: a propensity score-matched study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月26日

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  • Yohei Sasaki,
  • Manabu Matsunawa,
  • Hidenori Hayashi,
  • Natsuki Kawamata,
  • Kazuki Nagao,
  • Kai Kuroiwa,
  • Hinako Narita,
  • Reiko Okamura,
  • Shotaro Shimada,
  • Megumi Watanuki,
  • Nana Arai,
  • Yukiko Kawaguchi,
  • Kouji Yanagisawa,
  • Norimichi Hattori

摘要

The POLARIX trial demonstrated progression-free survival (PFS) benefit with polatuzumab vedotin-based therapy (Pola-R-CHP) over R-CHOP in diffuse large B-cell lymphoma (DLBCL). However, real-world data are limited for populations underrepresented in POLARIX, including patients with limited-stage disease, low international prognostic index (IPI) risk, or aged ≥ 81 years. We compared Pola-R-CHP and R-CHOP efficacy using propensity score matching (82 pairs from 86 to 189 patients, respectively). Patients newly diagnosed with DLBCL treated with Pola-R-CHP showed trends toward improved 2-year PFS overall (75.5% vs. 61.4%, p = 0.065), in limited-stage disease (96.0% vs. 73.8%, p = 0.057), and in low- IPI risk (100% vs. 81.2%, p = 0.11), with significant benefit in non-GCB subtype (76.3% vs. 51.0%, p = 0.013) compared to those with R-CHOP. No difference was detected between patients treated with Pola-R-CHP and R-CHOP aged ≥ 81 years (p = 0.43). In patients treated with Pola-R-CHP, age ≥ 81 years was an independent adverse factor for overall survival (OS) (HR 5.44, 95% CI 1.05–32.26, p = 0.044). This real-world study is consistent with POLARIX findings in non-GCB DLBCL and suggests potential benefits in limited-stage or low-IPI patients, though validation is needed. Results support Pola-R-CHP across diverse populations, with careful selection for treatment warranted in patients aged ≥ 81 years.