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1718 Using Polatuzumab Plus Chemotherapy for Patients with Relapsed/Refractory Diffuse Large B-Cell Lymphoma: A Real-World Study from the Grupo De Estudio De Linfoproliferativos De Latinoamerica (GELL)

Program: Oral and Poster Abstracts
Session: 626. Aggressive Lymphomas: Clinical and Epidemiological: Poster I
Hematology Disease Topics & Pathways:
Research, Lymphomas, Non-Hodgkin lymphoma, Clinical Research, Diseases, Real-world evidence, Lymphoid Malignancies
Saturday, December 7, 2024, 5:30 PM-7:30 PM

Luis Mario Villela Martinez, MD, MSc1,2*, Brady Beltran, MD3*, Alberto Villalobos Prieto, MD4, Ana Carolina Oliver, MD5, Marcela Elizabeth Zamora Matute6*, Maria Alejandra Torres Viera, MD7,8*, Seisha Alana von Glasenapp, MEd9, Yusaima Rodriguez-Fraga Sr., MD10*, Victoria Irigoin, MD5,11*, Sabrina Ranero Ferrari, MD11*, Maria Orlova, MD12*, German R. Stemmelin Sr., MD13*, Sofía Gabriela Rivarola, MD13*, Adrían Alejandro Ceballos López, MD14*, Jorge Montemayor, MD15, Martha Alvarado Ibarra16*, Alonso Hernandez17*, Daniela De Jesus Perez Samano18*, Álvaro Cabrera García19*, Natalia Pin Chuen Zing, MD20*, Myrna Candelaria, MD, PharmD21, Henry Idrobo, MD22*, Guilherme Fleury Perini, MD23, Rosa Oliday24*, Breno Gusmao, MD25*, Juan Daniel Garza Escobar Jr., MD26*, Marcelo Pitombeira de Lacerda, MD, PhD27,28*, Sally Paredes, MD3*, Virginia Lema Spinelli29*, Humberto Martinez-Cordero, MD30*, Rafael Martin De Jesus Pichardo Rodriguez, MD31,32*, Luis Enrique Malpica Castillo, MD33 and Jorge J. Castillo, MD34

1Hospital Fernando Ocaranza, Hermosillo, Mexico
2Centro Medico Dr. Ignacio Chavez, Hermosillo, Sonora, MEX
3Hospital Edgardo Rebagliati Martins, Lima, Peru
4Centro Medico ABC, Ciudad de Mexico, Mexico
5Bone marrow transplant unit, British Hospital, Montevideo, Uruguay
6Banco de Sangre, Hospital Metropolitano, Quito, ECU
7Unidad Linfomas, Instituto Hematología y Oncología Universidad Central Venezuela, Caracas, Venezuela (Bolivarian Republic of)
8Clinica Santa Sofia, Caracas, Venezuela (Bolivarian Republic of)
9Departamento de Hematologia, Instituo de Previsión Social, Asunción, Paraguay
10Hospital Clínico Quirúrgico “Hermanos Ameijeiras”, La Habana, Cuba
11Hospital de Clinicas, Montevideo, Uruguay
12Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
13Hospital Británico, Buenos Aires, Argentina
14Laboratorios Biomedicos de Merida, Merida, Mexico
15Hospital Universitario, Monterrey, MEX
16Hospital Angeles Lomas, Mexico, Mexico
17Hospital General de Mexico Eduardo Liceaga, Ciudad de Mexico, Mexico
18Hospital General de México, Mexico city, Mexico
192. Hematology Department, Regional Hospital of High Specialty of Ixtapaluca, Estado de México, Mexico., Ixtapaluca, Estado De México, Mexico, MEX
20Beneficência Portuguesa de São Paulo, São Paulo, AC, Brazil
21Clinical Research, Instituto Nacional de Cancerología, Mexico, Mexico
22Universidad del Valle del Cauca, Cali, COL
23Department of Medical Oncology, Hospital Israelita Albert Einstein, São Paulo, Brazil
24Hospital Militar Dr. Luis Diaz Soto, Havanna, Cuba
25Onco-Hematologia, Beneficência Portuguesa, São Paulo, Brazil
26Centro Medico Dr. Ignacio Chavez ISSSTESONA, Hermosillo Sonora, Mexico
27Universidade da Região de Joinville (Univille), Joinville, Santa Catarina, Brazil
28UNIFESP, SAO PAULO, Brazil
29Cátedra De Hematología Hospital De Clinicas, Montevideo, Uruguay
30SUBDIRECCIÓN GENERAL DE ATENCIÓN MEDICA Y DOCENCIA, INSTITUTO NACIONAL DE CANCEROLOGIA, Nariño, Colombia
31Hospital de Apoyo II-2 de Sullana, Piura, Peru
32Escuela de Medicina, Universidad César Vallejo, Piura, Peru
33Department of Lymphoma and Myeloma, University of Texas MD Anderson Cancer Center, Houston, TX
34Dana-Farber Cancer Institute, Bing Center for Waldenström Macroglobulinemia, Boston, MA

Background. Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma. Although DLBCL is curable in earlier stages, outcomes in relapsed/refractory (RR) disease are dismal, as shown in the SCHOLAR-1 study (Crump, Blood, 2017). The combination of the anti-CD79b antibody-drug conjugates (ADC) polatuzumab vedotin with rituximab and bendamustine (PRB) has been shown to be safe and effective in heavily pre-treated patients ineligible for transplant (Sehn, Blood 2022). However, there is little to no information on the use of polatuzumab-containing regimens in RR DLBCL in Latin America (LATAM) due to a delay in regulatory approvals in LATAM countries. Here, we present the first analysis of a cohort of RR DLBCL patients from LATAM treated with polatuzumab-containing regimens.

Aim. To present real-world data (RWD) of a cohort of patients with RR DLBCL in LATAM treated with polatuzumab-containing regimens.

Methods. This is a retrospective study of patients treated with polatuzumab-chemotherapy from January 2019 to April 2024 in Mexico, Uruguay, Ecuador, Cuba, Paraguay, Argentina, Venezuela, Peru, and Brazil. Patients aged ≥18 years were eligible if they had histologically confirmed RR DLBCL (WHO 2016 classification), cell of origin (COO) assessed (all patients were evaluated) and received ≥1 prior line of therapy. We described the clinical characteristics of the cohort and analyzed response, progression-free survival (PFS), and overall survival (OS) using Kaplan- Meier Curves and the possible variables that influenced survival PFS or OS through proportional-hazard Cox regression models.

Results. The cohort consisted of 58 patients. Frontline treatments included R-CHOP (90%), R-miniCHOP (5%), and R-EPOCH (5%). Of these 58 cases, the COO was determined in 93% (GC, 52%; non-GC, 41%), and 7% were unclassified; the Hans’ algorithm was used for COO assessment in 99%). The median age at diagnosis was 61 years, and at initiation of the polatuzumab-chemotherapy regimen was 65 (p=0.03); 52% were women. 17% were older than 75 at diagnosis, and 24% at the initiation of the polatuzumab-chemotherapy regimen. 90% of patients had an Ann Arbor III/IV stage at pola-chemotherapy initiation. Low, intermediate, and high-risk IPI scores were seen in 5%, 59%, and 36%, respectively. 81% were refractory to the last prior therapy. PRB was used in 90% of patients, and polatuzumab with other agents (obinutuzumab, lenalidomide, ICE, or DHAP) in 10%.

We observed a 61% overall response rate (ORR) with 42.5% complete response (CR), and 18.5% partial response (PR) rates and failure was observed in 39%. The median PFS of 54 patients was 12 months (95% CI 7 to 28); four patients are ongoing treatment and were not evaluable for PFS. The median OS of the 58 patients was 13 months (95% CI 11-28). In multivariate Cox models for PFS, non-GC COO subtype (HR 2.26; 95% CI 1.06 to 4.78) and refractory disease before using polatuzumab-chemotherapy (HR 4.41; 95% CI 1.04 to 18.5) were associated with an inferior PFS. The only variable associated to OS was response obtained after polatuzumab-chemotherapy (HR 2.21; 95% CI 1.56 to 3.12).

Conclusion. Using polatuzumab-containing regimens in our highly refractory cohort was associated with 61% responses, of which 42.5% were complete. Median PFS and OS were similar to previous reports and consistent with the poor outcomes these patients have. The non-GC COO subgroup might be associated with inferior PFS and OS in LATAM patients.

Disclosures: Oliver: Abbvie: Consultancy; Servier: Consultancy; Roche: Consultancy. Perini: BMS, Roche, Abbvie, AsstaZeneca, Beigene: Speakers Bureau. Castillo: Pharmacyclics: Consultancy, Research Funding; LOXO: Consultancy, Research Funding; Cellectar Biosciences: Consultancy, Research Funding; Kite Pharmaceuticals: Consultancy; AstraZeneca: Consultancy, Research Funding; BeiGene: Consultancy, Research Funding; AbbVie: Consultancy, Research Funding; Janssen: Consultancy; Mustang Bio: Consultancy.

*signifies non-member of ASH