POLARGO: Pola-R-GemOx delivers overall survival benefit in second-line DLBCL

The combination therapy of polatuzumab vedotin, rituximab, gemcitabine, and oxaliplatin (Pola-R-GemOx) was associated with significant improvements in survival outcomes as compared to R-GemOx without polatuzumab vedotin among patients with transplant-ineligible relapsed or refractory diffuse large B-cell lymphoma (DLBCL).

The phase 3 POLARGO study (NCT04182204) randomised 255 patients with transplant-ineligible DLBCL who had received at least 1 prior line of therapy 1:1 to pola-R-GemOx or to R-GemOx. The primary endpoint was overall survival (OS), and Dr Matthew Matasar (Rutgers Cancer Institute, NJ, USA) presented the results [1]. “Patients were stratified by age (<71 vs >70 years), prior lines of therapy, and whether they were relapsed or refractory,” added Dr Matasar.

After a median follow-up of 24.6 months, the median OS was 19.5 months in the polatuzumab arm and 12.5 months in the control arm (stratified HR 0.60; 95% CI 0.43-0.83; P=0.0017; See Figure). The corresponding 2-year OS rates were 44.0 months and 33.2 months, respectively. Moreover, the median progression-free survival was 7.4 months in the experimental arm and 2.7 months in the control arm, reflecting a stratified hazard ratio of 0.37 (95% CI 0.27-0.51; P<0.0001). “These survival benefits were seen in patients with ABC and GCB cell of origin disease,” mentioned Dr Matasar. Serious treatment-related adverse events (AEs) were reported in 28.1% of the patients on polatuzumab and in 22.4% of the patients on chemotherapy alone. In the polatuzumab arm, 11.4% of the patients had died from AEs, whereas this rate was only 4.0% in the control arm. “Fatal infections were observed in 7.8% of the patients in the experimental arm, mostly being COVID-19 infections,” Dr Matasar explained the rate of grade 5 AEs in the study. At the end of his talk, Dr Matasar said that 57.0% of the patients in the Pola-R-GemOx arm experienced any grade of peripheral neuropathy, whereas this rate was only 28.8% in the R-GemOx arm. “Fortunately, the peripheral neuropathy of 50.7% of the patients in the experimental arm improved or was resolved,” he said.

Figure: Pola-R-GemOx significantly improved OS vs R-GemOx in patients with R/R DLBCL [1]



OS, overall survival; CI, confidence interval; Pola-R-GemOx, polatuzumab vedotin + rituximab + gemcitabine + oxaliplatin; R-GemOx, rituximab + gemcitabine + oxaliplatin; NE, not estimable; HR, hazard ratio.

In conclusion, the data of the POLARGO trial demonstrate that combining polatuzumab vedotin with chemotherapy improves efficacy outcomes over chemotherapy alone in the second-line treatment of patients with transplant-ineligible DLBCL.

1. Matasar M, et al. Polatuzumab vedotin, rituximab, gemcitabine, and oxaliplatin (Pola-R-GemOx) for relapsed/refractory diffuse large B-cell lymphoma: Results from the randomized phase III POLARGO trial. S101, EHA2025 Congress, 12–15 June, Milan, Italy.

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Posted on 2 September 20252 September 2025