In short
Polatuzumab vedotin is an antibody-drug conjugate being studied in clinical trials for the treatment of various types of lymphoma, including diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma. This article summarizes key information from several clinical trials investigating polatuzumab vedotin alone or in combination with other drugs. The trials aim to evaluate the safety, efficacy, and optimal dosing of polatuzumab vedotin in patients with relapsed or refractory lymphomas.
At a glance
- Drug Name
- Polatuzumab vedotin
- Drug Type
- Antibody-drug conjugate
- Target
- CD79b on B cells
- Conditions Studied
- Diffuse large B-cell lymphoma, Follicular lymphoma, Other non-Hodgkin lymphomas, Hodgkin lymphoma
- Administration
- Intravenous infusion
- Common Dosing
- 1.8 mg/kg every 21 days
- Combination Therapies
- Rituximab, Obinutuzumab, Bendamustine, Cyclophosphamide, Doxorubicin, Prednisone, Glofitamab
- Key Outcomes Measured
- Overall response rate, Complete response rate, Progression-free survival, Duration of response, Overall survival, Safety/side effects, Pharmacokinetics
- Trial Phases
- Phase I, Phase II
- Patient Populations
- Relapsed/refractory lymphomas, Newly diagnosed lymphomas, Pre- and post-stem cell transplant
What is Polatuzumab Vedotin?
Polatuzumab vedotin is a medication used to treat certain types of blood cancers. It is known by the brand name Polivy. Polatuzumab vedotin is a type of drug called an antibody-drug conjugate (ADC). This means it combines a targeted antibody with a chemotherapy drug.
The medication has a few other scientific names you may hear, including:
- DCDS4501A
- RO7596
- FCU 2711
How Polatuzumab Vedotin Works
Polatuzumab vedotin works in a unique way to target and kill cancer cells. The antibody part of the drug attaches to a protein called CD79b, which is found on the surface of certain types of cancer cells. Once attached, the drug releases a potent chemotherapy agent called MMAE (monomethyl auristatin E) into the cancer cell.
MMAE works by stopping cancer cells from dividing and growing. It does this by interfering with structures inside the cell called microtubules, which are important for cell division. This mechanism is similar to how another chemotherapy drug called vincristine works.
Conditions Treated with Polatuzumab Vedotin
Polatuzumab vedotin is used to treat several types of blood cancers, including:
- Diffuse Large B-Cell Lymphoma (DLBCL): This is the most common type of non-Hodgkin lymphoma, a cancer that starts in white blood cells called lymphocytes.
- Follicular Lymphoma: Another type of non-Hodgkin lymphoma that typically grows slowly.
- High-Grade B-Cell Lymphoma: A fast-growing type of lymphoma.
- Burkitt Lymphoma: A rare but aggressive form of non-Hodgkin lymphoma.
- Mantle Cell Lymphoma: A rare type of B-cell non-Hodgkin lymphoma.
- Marginal Zone Lymphoma: A slow-growing type of B-cell non-Hodgkin lymphoma.
- Transformed Non-Hodgkin Lymphoma: When a slow-growing lymphoma changes into a more aggressive form.
- Richter Syndrome: A rare condition where chronic lymphocytic leukemia or small lymphocytic lymphoma transforms into an aggressive lymphoma.
- Hodgkin Lymphoma: A type of lymphoma that involves Reed-Sternberg cells.
Polatuzumab vedotin is often used when other treatments have not worked or when the cancer has come back after previous treatment.
How Polatuzumab Vedotin is Given
Polatuzumab vedotin is given as an intravenous (IV) infusion, which means it's delivered directly into your bloodstream through a vein. The typical dose is 1.8 milligrams per kilogram of body weight.
Treatment is usually given in cycles. Each cycle is typically 21 days for patients with diffuse large B-cell lymphoma and 28 days for patients with follicular lymphoma. The number of cycles can vary, but often patients receive up to 6 cycles of treatment.
Polatuzumab vedotin is often given in combination with other cancer medications. Common combinations include:
- Polatuzumab vedotin + bendamustine + rituximab (known as Pola-BR)
- Polatuzumab vedotin + rituximab + cyclophosphamide + doxorubicin + prednisone (known as Pola-R-CHP)
- Polatuzumab vedotin + obinutuzumab
Clinical Trials and Research
Polatuzumab vedotin has been and continues to be studied in various clinical trials. These studies help researchers understand how well the drug works, its safety, and how it compares to other treatments. Some key areas of research include:
- Using polatuzumab vedotin before stem cell transplants in patients with relapsed or refractory lymphoma.
- Combining polatuzumab vedotin with other medications for previously untreated lymphomas.
- Using polatuzumab vedotin after stem cell transplants.
- Studying the effectiveness of polatuzumab vedotin in real-world clinical practice.
- Investigating polatuzumab vedotin in combination with new drugs like mosunetuzumab for untreated follicular lymphoma.
- Exploring the use of polatuzumab vedotin in post-transplant lymphoproliferative disorder (PTLD).
- Testing polatuzumab vedotin as part of a treatment strategy before and after CAR-T cell therapy.
Potential Side Effects
Like all medications, polatuzumab vedotin can cause side effects. Common side effects may include:
- Fatigue
- Nausea
- Fever
- Decreased appetite
- Diarrhea
More serious side effects can include:
- Peripheral neuropathy: This is nerve damage that can cause numbness, tingling, or pain, usually in the hands and feet.
- Infections: The medication can lower your white blood cell count, making you more susceptible to infections.
- Infusion reactions: These can occur during or shortly after receiving the medication through IV.
- Tumor lysis syndrome: This is a condition that can occur when cancer cells break down quickly, releasing their contents into the blood.
Your healthcare team will monitor you closely for these and other potential side effects throughout your treatment.