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Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
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Salvage Using Polatuzumab Vedotin Based Therapy in Relapsed Refractory Large B-Cell Lymphomas: Early Experience from

V S Radhakrishnan1, R Pincha1, V Raina1

  • 1Department of Clinical Hematology Oncology and HCT, Tata Medical Center, Newtown, Kolkata, 700160 India.

Indian Journal of Hematology & Blood Transfusion : an Official Journal of Indian Society of Hematology and Blood Transfusion
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Summary

Polatuzumab vedotin offers a feasible and safe treatment option for relapsed/refractory large B-cell lymphoma in India. This real-world study shows manageable adverse events and promising response rates in a limited patient cohort.

Keywords:
Compassionate useDiffuse large B cell lymphomaLow–middle income countriesPolatuzumab vedotinRelapsed/refractorySalvage therapy

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Area of Science:

  • Hematology
  • Oncology
  • Immunotherapy

Background:

  • Polatuzumab vedotin is an antibody-drug conjugate targeting CD79b for relapsed/refractory large B-cell lymphoma.
  • Its high cost limits access in Lower-Middle Income Countries (LMIC) like India.

Purpose of the Study:

  • To evaluate the feasibility, safety, and efficacy of Polatuzumab vedotin-based salvage therapy in adult patients with R/R large B-cell lymphoma in India.
  • To assess the real-world outcomes of this novel immunotherapy in an LMIC setting.

Main Methods:

  • Retrospective study of 10 adult patients with R/R large B-cell lymphoma receiving Polatuzumab vedotin via compassionate or named-patient access.
  • Data collected from May 2019 to April 2022.
  • Common regimen: Polatuzumab-Bendamustine-Rituximab.

Main Results:

  • Nine patients were evaluable; 4 achieved complete response (CR), 2 partial response (PR), and 3 progressive disease (PD).
  • Adverse events were manageable: one grade-2 infusion reaction, four grade 3-4 hematological toxicities, and no grade 3-4 non-hematological toxicities.
  • Median follow-up was 491 days; four patients survived (three in CR, one in PR).

Conclusions:

  • Polatuzumab vedotin-based therapy is feasible and demonstrates a favorable safety profile in an LMIC setting.
  • Encouraging response rates were observed in a subset of patients, suggesting potential benefit despite access challenges.
  • Further research and strategies to improve access are warranted for wider application in LMICs.