The efficacy of polatuzumab vedotin targeting CD79B in the treatment of non-Hodgkin lymphoma: A systematic review and meta-analysis.

Abstract

e19085 Background: Non-Hodgkin lymphoma (NHL) represents a heterogeneous group of lymphoid malignancies with a substantial proportion of patients developing relapsed or refractory disease despite standard immunochemotherapy. Polatuzumab vedotin, an antibody-drug conjugate targeting CD79B, has emerged as a novel therapeutic option aimed at improving response and survival outcomes in this high-risk population. However, variability in reported efficacy and safety across studies necessitates a comprehensive synthesis of available evidence. This systematic review and meta-analysis evaluates the effectiveness and safety of Polatuzumab based regimens in patients with NHL. Methods: This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. A systematic search of PubMed, EMBASE, and Web of Science identified studies published up to January 2026 comparing Polatuzumab-based therapy with control regimens in NHL. Fifteen eligible studies were included. Outcomes assessed were complete response (CR) rates, progression-free survival (PFS), overall survival (OS), and adverse events including neutropenia, fatigue, and diarrhea. Meta-analysis was performed using common-and random-effects models, with pooled risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes. Results: Fifteen studies encompassing a total of 2553 patients (1298 Polatuzumab; 1255 control) were included. Polatuzumab based therapy significantly improved complete response rates compared with control (RR 1.29; 95% CI 1.01–1.64). Progression-free survival was significantly prolonged (MD 4.16 months; 95% CI 1.22–7.10). Overall survival showed no statistically significant difference between groups (RR 1.27; 95% CI 0.69–2.32). Among adverse events, neutropenia rates were comparable (RR 1.08; 95% CI 0.79–1.46), while fatigue showed no significant increase (RR 3.73; 95% CI 0.22–62.12). Diarrhea occurred more frequently with Polatuzumab-based therapy (RR 2.31; 95% CI 0.85–6.31). Conclusions: Polatuzumab vedotin-based therapy significantly improves complete response rates and progression-free survival in patients with Non-Hodgkin lymphoma without a corresponding increase in overall mortality. While gastrointestinal toxicity warrants attention, the overall safety profile remains acceptable. These findings support Polatuzumab vedotin as an effective targeted therapeutic strategy in the management of relapsed or refractory NHL.