R-Pola-CHP Regimen for diffuse large B-cell lymphoma (DLBCL)
Schedule and Dosing
The treatment is administered over six cycles, each lasting 21 days:
- Polatuzumab vedotin: 1.8 mg/kg IV on day 1 of each cycle
- Rituximab: 375 mg/m² IV on day 1 of each cycle
- Cyclophosphamide: 750 mg/m² IV on day 1 of each cycle
- Doxorubicin: 50 mg/m² IV on day 1 of each cycle
- Prednisone: 100 mg orally on days 1-5 of each cycle
Administration Details
– Day 1: Rituximab, polatuzumab vedotin, cyclophosphamide, and doxorubicin are administered intravenously. For the first cycle, these drugs may be given over two days to monitor for reactions.
– Days 1-5: Prednisone is taken orally.
Toxicity Profile
- Neutropenia: 90% of patients experienced some degree of neutropenia[1].
- Peripheral neuropathy: 53% of patients reported new or worsening peripheral neuropathy[1].
- Fatigue: Common in both R-Pola-CHP and R-CHOP regimens.
- Nausea: Frequently reported.
- Diarrhea: Higher incidence of grade 3/4 diarrhea (3.9%) compared to R-CHOP (1.8%)[1].
Serious Adverse Events
- Febrile neutropenia: Higher incidence with R-Pola-CHP (13.8%) compared to R-CHOP (8.0%)
- Infections: Grade 3-4 infections occurred in 14% of patients
- Hepatotoxicity: Grade 3-4 elevation of liver enzymes (ALT and AST) in 1.4% and 0.7% of patients, respectively