ASH 2025 | A retrospective study of Pola-R-CHP versus R+DA-EPOCH in high-risk DLBCL

As we know, DLBCL is the most common aggressive B-cell lymphoma. With standard molecular profiling, cytogenetic, we can stratify standard versus high-risk DLBCL patients. And newly approved, based on the POLARIX trial, Pola-R-CHP is getting used in the high-risk DLBCL stage. Previously, up to now, all those very high-risk patients were previously treated with EPOCH therapy that we call dose-adjusted EPOCH therapy that has been standard in the past. But now with the POLARIX trial, we wanted to see if this high-risk patient can be treated with a Pola-R-CHP. So we conducted a retrospective study comparing all our data for the last 20 years treated at Roswell Park. We had more than 260 patients total. We conducted a study of 234 patients that were treated in the EPOCH arm versus 23 patients in the Pola-R-CHP arm, trying to see what’s the anti-tumor effect and what are the side effect profiles compared to both of these drugs. So we found out based on propensity score match we were able to generate 23 patients in Pola-R-CHP and 46 patients in EPOCH arm and we were able to significantly find the PFS and overall survivals trend towards better in Pola-R-CHP arm and also significantly less toxicity in the Pola-R-CHP arm. Like the grade three neutropenia, grade three hospital requirement, any clot ICU admission were pretty less in Pola-R-CHP arm. And I think this is the first study comparing Pola-R-CHP with EPOCH in high-risk patients. And I think that should be implemented soon in clinical practice.

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