Interim efficacy and preliminary survival outcomes of polatuzumab vedotin in combination for diffuse large B-cell lymphoma: a retrospective real-world study.

PURPOSE: The standard first-line R-CHOP regimen achieves cure in only approximately 50% of patients. Polatuzumab vedotin (Pola) is a novel antibody-drug conjugate targeting the B-cell receptor component CD79b; however, evidence regarding its real-world efficacy remains relatively limited. This retrospective study aims to evaluate the clinical efficacy of Pola in combination therapy. METHODS: A retrospective analysis was conducted on 140 patients with complete clinical records treated at the Affiliated Hospital of Qingdao University between September 2022 and September 2025. Among them, 114 patients received combination regimens containing Pola, while 26 patients received regimens without Pola. Given the limited follow-up duration, this study primarily assessed interim efficacy, with preliminary survival data also reported. RESULTS: Among the 140 eligible patients, 4 deaths and 20 disease progressions occurred. The age range was 23-91, with a median age of 67; 45.0% were female. An ECOG performance status ≥2 was observed in 16.4% of patients, and 20.7% presented with B symptoms. Elevated LDH levels were found in 57.9% of patients. Ann Arbor stage III or IV disease was present in 65.0% of patients, and an IPI score >2 was recorded in 50.7%. Double-expressor lymphoma was diagnosed in 40.0% of cases. Bone marrow involvement was detected in 20.0% of patients, while 83.6% had lymph node extracapsular extension. Immunohistochemistry staining showed 36 patients (25.7%) with GCB subtype and 99 patients (70.7%) with non-GCB subtype. Median follow-up was 11 months (95% CI: 10.85-13.15). The objective response rate (ORR) was 94.4% in the Pola group and 70.0% in the non-Pola group (OR = 7.1, 95% CI: 2.0-27.2, P<0.001). Complete remission (CR) rates were 53.7% and 20.0%, respectively (OR = 4.6, 95% CI: 1.7-14.9, P = 0.002). The Pola group showed a statistically significant advantage in progression-free survival (PFS). Six-month PFS rates were 90.4% (95% CI: 84.8%-96.3%) for the Pola group and 76.9% (95% CI: 62.3%-94.9%) for the non-Pola group, while 12-month PFS rates were 87.2% (95% CI: 80.5%-94.6%) and 67.9% (95% CI: 51.7%-89.2%), respectively. CONCLUSION: Combination regimens containing Polatuzumab vedotin demonstrated a marked interim efficacy advantage, which may translate into potential long-term survival benefits.