Real-World Pola-R-CHP vs R-CHOP Effectiveness in Older DLBCL Patients

Matthew Matasar, MD, medical oncologist at Rutgers Cancer Institute, presents the results of a retrospective study investigating the real-world effectiveness of polatuzumab vedotin (Polivy) plus R-CHP (Pola-R-CHP) compared with R-CHOP as a first-line treatment for diffuse large B-cell lymphoma (DLBCL) in Medicare beneficiaries in the United States. Pola-R-CHP has previously demonstrated a sustained progression-free survival (PFS) benefit over R-CHOP in the POLARIX trial.

Data for this study were sourced from the 100% Medicare fee-for-service claims database from April 2022 to December 2024. Patients included were aged ≥66 years with DLBCL and no prior systemic treatment. A total of 1064 patients treated with Pola-R-CHP and 3642 patients treated with R-CHOP were identified.

Patients receiving Pola-R-CHP were found to be more likely to be male (58% vs 54%), younger (mean age, 75.0 vs 77.5 years), and have a lower Charlson comorbidity score (2.6 vs 2.8) compared with those receiving R-CHOP⁶⁶⁶⁶. Both groups received a similar mean number of cycles (4.8 cycles, median 5 cycles).

The primary outcome, time to next treatment or death (TTNT-D), used as a proxy for PFS, showed improvement for the Pola-R-CHP group:

• 6 months: 88% TTNT-D vs 83% for R-CHOP
• 12 months: 81% TTNT-D vs 73% for R-CHOP¹

After adjusting for baseline characteristics, Pola-R-CHP resulted in significantly fewer patients with second-line treatment or death (17% vs 25% for R-CHOP), with an adjusted hazard ratio (HR) of 0.79 (95% CI, 0.67–0.93).

For the secondary outcome, overall survival (OS), a nonsignificant trend towards improved OS was observed with Pola-R-CHP. The adjusted HR for OS was 0.88 (95% CI, 0.72–1.07).

The study concluded that after adjusting for differences in patient characteristics, Pola-R-CHP demonstrated significant improvements in TTNT-D and a trend towards improved OS compared with R-CHOP. These data provide additional evidence for the effectiveness of Pola-R-CHP as a first-line treatment in an older US Medicare population with DLBCL.

REFERENCE

Matasar M. Real-world effectiveness of polatuzumab vedotin plus rituximab, cyclophosphamide, doxorubicin and prednisone (R-CHP) compared with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) among elderly Medicare beneficiaries with diffuse large B-cell lymphoma (DLBCL) in the United States. Presented at: 67th ASH Annual Meeting; December 6–9, 2025; Orlando, Florida. Abstract 4486.