Comparison between Pola-R-CHP and R-CHOP regimens in patients newly diagnosed with diffuse large B-cell lymphoma: a propensity score-matched study

The POLARIX study revealed that the polatuzumab vedotin, rituximab, cyclophosphamide, doxorubicin, and prednisolone (Pola-R-CHP) regimen showed a progression-free survival (PFS) benefit over the rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) regimen. However, it remains unclear whether the Pola-R-CHP regimen can be an appropriate standard therapy for patients newly diagnosed with diffuse large B-cell lymphoma (DLBCL) based on real-world data. This study compared the efficacy of the Pola-R-CHP and R-CHOP regimens and elucidated the clinical prognostic factors for patients newly diagnosed with DLBCL treated with Pola-R-CHP. Propensity score matching was performed on 86 and 189 patients who received Pola-R-CHP and R-CHOP, respectively, with 82 selected in each arm. Patients treated with Pola-R-CHP tended to have better PFS than those treated with R-CHOP (1-year PFS: 85.2% vs 77.5%, p = 0.065). Patients exhibiting limited-stage disease, at low international prognostic index (IPI) risk, or those aged ≥ 81 years treated with Pola-R-CHP tended to have better 1-year PFS than those treated with R-CHOP (96.0% vs 86.1%, p = 0.057, 100% vs 88.9%, p = 0.11, 75.7% vs 70.6%, p = 0.43, respectively). In the multivariate analysis for 86 patients treated with Pola-R-CHP, clinical factors affected by PFS were not noted, while age (≥ 81 years or not) emerged as a clinical factor affected by OS (95% confidence interval: 1.05–32.26, p = 0.044). Pola-R-CHP could be more appropriate as a treatment for patients exhibiting limited-stage disease, those at lower international prognostic index (IPI) risk, or those aged ≥ 81 years newly diagnosed with DLBCL.