Polatuzumab Vedotin

Approved for use in combination with bendamustine and rituximab (BR) for the treatment of patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL) who have received at least 2 prior therapies.

Polivy is the trade name.

It is an antibody-drug conjugate targeted immunotherapy.

Humanized monoclonal antibody

Targets CD79B

Pregnancy category AU: D

CD79b is a component of the B-cell receptor and is expressed significantly in DLBCL.

Polatuzumab vedotin is an anti-CD79b antibody linked to microtubule-disrupting monomethyl auristatin E.

It is a monoclonal antibody directed against CD 79.

Signal transmission from B-cell receptors goes through CD79 to cytoplasmic kinases.

Upon binding to CD79, the antibody is internalized and from there the mechanism of action is similar to brentuximab.

It induces cell cycle arrest and apoptosis in lymphoma cells.

Limited studies suggest in relapsed/ refractory patients with DLBCL the objective response rate was 41% with a median ration of response was 28.4 months, progression free survival was 5.4 months and overall survival 10.8 months.

Analyses by cell of origin of activated B-cell like (ABC) or germinal B-cell like (GCB), showed advantages for the addition of polatuzumab vedotin.

Effective in DLBCL with Cyclophoshamide, Adriamycin and prednisone (R-CHP) and in combination with Bendamustine plus rituximab.

Polatuzumab vedotin is indicated in combination with bendamustine and a rituximab product for the treatment of adults with relapsed or refractory diffuse large B-cell lymphoma.

Polivy in combination with rituximab, cyclophosphamide, doxorubicin, and prednisone (R-CHP) is indicated for the treatment of adults with previously untreated diffuse large B-cell lymphoma (DLBCL).

Associated with the incremental improvements in progression  free survival with RCHP  versus R-CHOP.

FDA has approved polatuzumab vedotin in combination with rituximab, cyclophosphamide, doxorubicin and prednisone as first-line therapy for people with previously untreated diffuse large B-cell lymphoma, not otherwise specified or high-grade B-cell lymphoma who have an International Prognostic Index score of two or greater.

The main adverse effects include: neuropathy and cytopenias.

The most common side effects include neutropenia, thrombocytopenia and anemia, peripheral neuropathy, fatigue; diarrhea; fever; decreased appetite; and pneumonia.

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