Polatuzumab offers new hope for DLBCL patients on World Lymphoma Day

New Delhi: As World Lymphoma Day approaches, a breakthrough in the treatment of Diffuse Large B-cell lymphoma (DLBCL) offers new hope for patients battling this aggressive form of blood cancer. In a recent development, the first FDA-approved therapy for first-line DLBCL treatment in almost 20 years is now available in India. 

This innovative treatment, Polatuzumab combined with chemotherapy, represents a major advancement in the fight against DLBCL, a type of non-Hodgkin lymphoma. With an estimated 25,000 new DLBCL cases diagnosed annually in India, the need for advanced treatment options is urgent. Despite progress, nearly 40% of patients experience relapse or disease progression, creating significant challenges for individuals and the healthcare system.

This approach has shown a 27% reduction in the risk of progression, relapse, or death as compared to the existing standard-of-care of MabThera/Rituxan plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP). Notably, 77% of patients treated with Polatuzumab have remained progression-free for two years.

Globally, Polatuzumab has been administered to over 23,000 patients in first-line settings and has received approval in more than 90 countries, highlighting its substantial international impact. It has now also been included as a preferred treatment regimen for DLBCL under the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology.

DLBCL, while highly treatable, poses a serious risk of relapse or progression, particularly among patients with returning disease. In India, approximately 30-40% of individuals diagnosed with DLBCL do not survive beyond five years, a statistic worse than the global average. Misdiagnosis and delayed referrals by general physicians often compromise treatment efficacy, adding to the emotional and psychological burden on patients and their families.

The new therapy, Polatuzumab, is a first-in-class anti-CD79b antibody-drug conjugate. It targets specific proteins in lymphoma cells and delivers cytotoxic agents directly to the cancer cells. This success represents a significant breakthrough, especially considering that since the introduction of chemotherapy in 2002, approximately 11 clinical trials have not managed to show improved outcomes for DLBCL.

Experts emphasize that early and accurate diagnosis, combined with advanced treatments like Polatuzumab, can significantly improve patient outcomes. Dr. Sajjan Rajpurohit, Senior Director at BLK-Max Super Speciality Hospital, stressed, “One of the key challenges in treating DLBCL is misdiagnosis and delayed referrals from general physicians, which can disrupt the patient’s treatment journey and compromise effectiveness. Since the symptoms of DLBCL can be non-specific, they are sometimes mistaken for more common infections like tuberculosis, leading to delays in proper diagnosis. Early and accurate diagnosis, followed by timely initiation of advanced treatment options like Polatuzumab can significantly improve outcomes, leading to complete remission and reduced mortality rates.”

 Dr. Pawan Singh, Director of Hematology at Yatharth Super Speciality Hospital, highlighted, “In cases of Diffuse Large B- Cell Lymphoma (DLBCL), 40% of patients relapse or progress after first-line therapy. Hence there is a need for newer and better therapies in the first line to improve outcomes. By adopting innovative therapies like polatuzumab as the new standard of care (SoC) in first-line treatment, we can increase their chances of cure, while also easing the financial and emotional burden that comes with relapse or disease progression. This shift would be crucial in improving both survival rates and quality of life for DLBCL patients in India.”

Dr. Sushant Mittal, Director of Medical Oncology at Action Cancer Hospital, underscored, “First-line treatment for DLBCL presents the best opportunity for a successful outcome. Most relapses occur within the first 24 months of starting treatment, but patients who don’t progress during this period have better survival rates. Hence it is crucial to offer the most effective treatment option in the first-line setting to reduce the risk of disease progression and increase the chances of a curative outcome.”