Polatuzumab Vedotin (Polivy)

CADTH recommends that Polivy in combination with rituximab, cyclophosphamide, doxorubicin, and prednisone (R-CHP) not be reimbursed by public drug plans for the treatment of adult patients with previously untreated large B-cell lymphoma (LBCL), including diffuse large B-cell lymphoma (DLBCL) not otherwise specified (NOS), high-grade B-cell lymphoma, Epstein-Barr virus–positive DLBCL NOS, and T-cell/histiocyte-rich LBCL. Evidence from a clinical trial showed that 6.6% more patients with newly diagnosed moderate- to high-risk LBCL were alive without their disease progressing 2 years after treatment with Polivy in combination with R-CHP compared to those treated with traditional chemoimmunotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone [R-CHOP]). However, there is uncertainty whether this difference observed in the clinical trial translates to a meaningful difference in the real world. The evidence from the trial did not show that Polivy combined with R-CHP prolonged survival compared to R-CHOP. It is also unknown if Polivy in combination with R-CHP would reduce disease symptoms or improve functioning compared to R-CHOP because there were no differences between the 2 groups. Patients identified a need for treatments that prolong disease remission, prolong survival, control disease symptoms, normalize blood counts, and improve quality of life. Based on the evidence submitted, it is not clear that Polivy in combination with R-CHP would provide a meaningful benefit in prolonging remission or meet the other important needs in LBCL.