Initial safety run-in results of the phase III POLARGO trial: Polatuzumab vedotin plus rituximab, gemcitabine, and oxaliplatin in patients (pts) with relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL).

Authors

null

Matthew J. Matasar

Memorial Sloan Kettering Cancer Center, New York, NY

Matthew J. Matasar , Corinne Haioun , Juan-Manuel Sancho , Andreas Viardot , Antonia Rodriguez Izquierdo , Eva Maria Donato Martin , Alejandro Martin Garcia-Sancho , Jose David Sandoval-Sus , Herve Tilly , Elizabeth Vandenberghe , Jamie Hirata , Priya Choudhry , Yi Meng Chang , Lisa Musick , Andrew McMillan

Organizations

Memorial Sloan Kettering Cancer Center, New York, NY, Lymphoid Malignancies Unit, Groupe Hospitalier Henri Mondor, Créteil Cedex, France, ICO-HU Germans Trias I Pujol, Barcelona, Spain, University Hospital of Ulm, Ulm, Germany, Hospital Univ 12 De Octubre Servicio de Hematologia, Madrid, Spain, Hospital Universitario Dr Peset Servicio de Hematologia, Valencia, Spain, Hospital Clinico Universitario de Salamanca Servicio de Hematologia, Salamanca, Spain, Moffitt Cancer Center at Memorial Healthcare Institute, Pembroke Pines, FL, Department of Hematology and U1245, Centre Henri Becquerel and University of Rouen, Rouen, France, St. James Hospital Cancer Clinical Trials Office, Dublin, Ireland, Genentech, Inc., South San Francisco, CA, F. Hoffmann-La Roche Ltd., Mississauga, ON, Canada, Centre for Clinical Haematology, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom

Research Funding

Pharmaceutical/Biotech Company

Background: Transplant-ineligible pts with R/R DLBCL have a poor prognosis (Gisselbrecht C, et al. Br J Haematol 2018). Several treatment options are available including platinum-based chemotherapies such as oxaliplatin plus rituximab and gemcitabine (R-GemOx). Adding polatuzumab vedotin to R-GemOx (Pola-R-GemOx) may improve outcomes for pts with a continued unmet medical need. The safety of polatuzumab vedotin and platinum-based therapy combinations must be considered as both are associated with neuropathy. POLARGO (NCT04182204; MO40598) is a Phase III, multicenter, open-label, randomized trial evaluating the safety and efficacy of Pola-R-GemOx vs R-GemOx in pts with R/R DLBCL. Methods: Results from the safety run-in stage of POLARGO are presented. The primary endpoint is the safety and tolerability of polatuzumab vedotin (1.8 mg/kg) + R-GemOx (R, 375 mg/m2; Gem, 1000 mg/m2; Ox, 100 mg/m2) given every 21 days for up to 8 cycles. Safety was assessed by the incidence, nature, and severity of adverse events (AEs; NCI CTCAE v5.0), with a focus on peripheral neuropathy (PN). Dose interruptions and reductions were used to assess tolerability. Granulocyte-colony stimulating factor was given as primary prophylaxis with each cycle (C) of therapy; anti-infective prophylaxis for pneumocystis and herpes virus was mandatory. Results: As of October 26, 2021, 15 pts were enrolled and 11 (73%) pts received ≥4 cycles of Pola-R-GemOx. Median age was 76 (range 47–87) years, 10 (67%) pts had an IPI score of 3–5, 7 (47%) had ≥2 prior therapy lines, and 8 (53%) were refractory to last treatment. Grade (Gr) 3–4 AEs were reported in 5 (33%) pts: thrombocytopenia (20%) and neutropenia (13%) were the most common. Two (13%) pts had serious AEs (Gr 3 febrile neutropenia and Gr 3 infection [n = 1 each]). There were no Gr 5 AEs or AEs leading to drug discontinuation. Eight (53%) pts had Gr 1 or 2 PN; there were no cases of Gr >3 PN. Three (20%) pts had drug interruptions due to PN. Two (13%) pts had a dose reduction of polatuzumab vedotin and oxaliplatin due to PN at C5 and C8, respectively; one pt (7%) had a dose reduction of polatuzumab vedotin due to Gr 4 thrombocytopenia at C2. End-of-treatment (EOT) objective response rate was 40% (95% CI: 16–68) and complete response rate was 27% (95% CI: 8–55); 7 (47%) pts had progressive disease at EOT. Ten (67%) pts received subsequent therapies following Pola-R-GemOx, including CAR-T cell therapy (n = 3) and stem-cell transplant (n = 1). Conclusions: In the safety run-in stage, Pola-R-GemOx was safe and tolerable. PN was manageable with dose interruptions and reductions; no cases of Gr ≥3 PN were observed. The toxicity of this combination did not compromise delivery of subsequent treatments. POLARGO is currently enrolling pts to receive Pola-R-GemOx vs R-GemOx; results will be presented at a future meeting. Clinical trial information: NCT04182204.

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia

Track

Hematologic Malignancies

Sub Track

Non-Hodgkin Lymphoma

Clinical Trial Registration Number

NCT04182204

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 7551)

DOI

10.1200/JCO.2022.40.16_suppl.7551

Abstract #

7551

Poster Bd #

204

Abstract Disclosures