The safety run-in stage (Stage 1) will assess the safety of polatuzumab vedotin plus
rituximab, gemcitabine and oxaliplatin (Pola-R-GemOx) in 10 participants. The randomized
controlled trial (RCT) (Stage 2) will compare Pola-R-GemOx versus R-GemOx in 206
participants.
Inclusion Criteria:
- Histologically-confirmed diffuse large B-cell lymphoma, not otherwise specified (NOS)
or history of transformation of indolent disease to DLBCL
- Relapsed disease (disease that has recurred following a response that lasted ≥ 6
months from completion of the last line of therapy) or refractory disease (disease
that progressed during therapy or progressed within 6 months (< 6 months) of prior
therapy)
- At least one (≥ 1) line of prior systemic therapy:
- Patients may have undergone autologous hematopoietic stem cell transplantation (HSCT)
prior to recruitment; chemotherapy followed by consolidative autologous HSCT will be
counted as one line of therapy
- Patients may have undergone allogeneic HSCT prior to recruitment, so long as they are
off all immunosuppressive therapy and have no active GVHD; chemotherapy followed by
allogeneic HSCT will be counted as one line of therapy
- Local therapies (e.g., radiotherapy) will not be considered as lines of treatment
- At least one bi-dimensionally measurable lesion, defined as > 1.5 cm in its longest
dimension as measured by CT or MRI
- Eastern Cooperative Oncology Group (ECOG) performance status of 0,1 or 2
- Adequate hematological function
- For women of childbearing potential: agreement to remain abstinent (refrain from
heterosexual intercourse) or use contraception, and agreement to refrain from donating
eggs
- For men: agreement to remain abstinent (refrain from heterosexual intercourse) or use
contraceptive measures, and agreement to refrain from donating sperm,
Exclusion Criteria:
- History of severe allergic or anaphylactic reactions to humanized or murine monoclonal
antibodies (or recombinant antibody-related fusion proteins) or known sensitivity or
allergy to murine products
- Contraindication to rituximab, gemcitabine or oxaliplatin
- Peripheral neuropathy assessed to be > Grade 1 according to NCI CTCAE v5.0
- Prior use of polatuzumab vedotin or a gemcitabine plus platinum-based agent
combination, recent participation in a clinical trial, and/or treatment with
radiotherapy, chemotherapy, immunotherapy, immunosuppressive therapy within 2 weeks
- Planned autologous or allogenic stem cell transplantation at time of recruitment
- Primary or secondary central nervous system (CNS) lymphoma
- Richter's transformation or prior CLL
- Abnormal laboratory values or health conditions, as assessed by the investigator, any
known conditions preventing adherence to protocol or active bacterial, viral, fungal,
mycobacterial, parasitic, or other infection
- Vaccination with a live vaccine within 4 weeks prior to treatment
- Recent major surgery (within 6 weeks before the start of Cycle 1 Day 1) other than for
diagnosis
- Any other diseases, metabolic dysfunction, physical examination finding, or clinical
laboratory finding giving reasonable suspicion of a disease or condition that
contraindicates the use of an investigational drug or that may affect the
interpretation of the results or render the patient at high risk from treatment
complications
- Pregnant or breastfeeding, or intending to become pregnant during the study or within
12 months after the last dose of study drug
- Women of childbearing potential must have a negative serum pregnancy test result
within 7 days prior to initiation of study drug