Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma. 1 The addition of rituximab has yielded substantial improvement in patient outcomes, but up to 40% of patients will have disease that is refractory to this treatment or will have a relapse after an initial response. Approximately 50% of patients with relapsed or refractory (R/R) DLBCL are ineligible for standard treatment with and prognoses for these patients are poor. Today, new approaches to the treatment of patients with DLBCL and R/R DLBCL are being developed to obtain stable remission. An overview of the clinical use of the antibody-drug conjugate polatuzumab vedotin in combination with rituximab, cyclophosphamide, doxorubicin, and prednisone in first-line therapy and polatuzumab vedotin in combination with bendamustine plus rituximab in second-line therapy is provided. Among patients with DLBCL, first-line treatment with the pola-R-CHP combination showed a progressionfree survival benefit over the R-CHOP regimen at 2 years. Common second-line options for patients refractory to first-line therapy include rituximab plus gemcitabine and oxaliplatin, as well as bendamustine plus rituximab. They were evaluated in patients in patients with transplantation-ineligible R/R DLBCL. However, there is no defined standard of care. Several treatments have now been approved in the secondline setting and beyond, including the antibody–drug conjugate polatuzumab vedotin in combination with bendamustin and rituximab. In the randomized cohort, after a median follow-up of 22.3 months polatuzumab vedotin in combination with bendamustin and rituximab significantly improved the survival of patients with R/R DLBCL compared with bendamustin and rituximab alone. Biomarker analysis showed that this combination was beneficial in all patients, regardless of lymphoma status. Median assessed progression-free survival and overall survival were 6.6 months and 12.5 months, respectively. No new safety signals with pola+BR were identified. Pola+BR is an effective treatment option for patients with R/R DLBCL, with a well-characterized and manageable safety profile.

Keywords: review, diffuse large B-cell lymphoma, polatuzumab vedotin, rituximab, bendamustin.