polatuzumab vedotin at a glance
Medicine class
CD79b-directed antibody–drug conjugate
Main use
Diffuse large B-cell lymphoma in adults
Administration
Intravenous infusion given by an experienced cancer-treatment team
Important monitoring
Blood counts, infection, nerve symptoms, liver function and infusion reactions
What is polatuzumab vedotin used for?
Licensed uses in adults with DLBCL are:
Previously untreated DLBCL, in combination with rituximab, cyclophosphamide, doxorubicin and prednisone.
Relapsed or refractory DLBCL in people who are not candidates for haematopoietic stem-cell transplantation, in combination with bendamustine and rituximab.
How does polatuzumab vedotin work?
The antibody part binds CD79b, a protein found on B cells. The complex is taken into the cell, where its MMAE component is released and disrupts microtubules, stopping cell division and promoting death of malignant B cells.
polatuzumab vedotin preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 30 mg, 140 mg
How to take polatuzumab vedotin
Polatuzumab vedotin is not taken by mouth. A healthcare professional prepares it and gives it as an intravenous infusion through a dedicated filtered line. Medicines to reduce fever and infusion reactions are normally given beforehand, with observation during and after administration.
Tell the team promptly about symptoms during or after the infusion.
Immediately report pain, burning or swelling around the infusion site.
It must not be given as an intravenous push or bolus.
polatuzumab vedotin side effects
Common or expected effects
- Low white blood cells, platelets or red blood cells
- Infections, including pneumonia and upper respiratory infections
- Numbness, tingling, burning pain or weakness from peripheral neuropathy
- Diarrhoea, nausea, vomiting, constipation or abdominal discomfort
- Fever, tiredness, weakness or reduced appetite
- Cough, mouth inflammation, hair loss or weight loss
- Infusion-related reactions
Get urgent medical advice
- Severe infection or neutropenic fever
- Severe allergic or infusion-related reaction
- Unusual bleeding caused by low platelets
- New or worsening neurological changes suggesting progressive multifocal leukoencephalopathy
- Breathlessness from pneumonia or lung inflammation
- Jaundice or other evidence of liver injury
- Tumour lysis syndrome
- Skin or tissue injury following leakage around the infusion site
polatuzumab vedotin in pregnancy
Polatuzumab vedotin may harm an unborn baby and is not recommended during pregnancy unless the specialist considers the potential benefit greater than the risk. Pregnancy status should be checked before treatment. Effective contraception is advised during treatment and for at least 9 months afterwards for women who could become pregnant, and during treatment and for at least 6 months afterwards for men with partners who could become pregnant.
polatuzumab vedotin while breastfeeding
It is unknown whether polatuzumab vedotin or its metabolites enter breast milk, and harm to a breastfed child cannot be excluded. Breastfeeding should stop during treatment and for at least 3 months afterwards; discuss feeding plans with the specialist team.
polatuzumab vedotin interactions
Give the cancer team a complete list of prescribed, non-prescribed and herbal products. Relevant interactions include:
Strong CYP3A4 or P-glycoprotein inhibitors, including clarithromycin, itraconazole, posaconazole, voriconazole, ritonavir and cobicistat
These may increase exposure to unconjugated MMAE, so closer monitoring for toxicity may be needed.
Strong CYP3A4 inducers, including rifampicin, carbamazepine, phenytoin, phenobarbital and St John’s wort
These may reduce exposure to unconjugated MMAE and potentially alter treatment activity.
Live or live-attenuated vaccines
These should not be given concurrently because treatment suppresses immune function; vaccination plans require specialist review.
Common questions about polatuzumab vedotin
Answers are fully visible for fast scanning and source review.
What type of cancer does polatuzumab vedotin treat?
It is licensed for adults with diffuse large B-cell lymphoma, including previously untreated disease and certain relapsed or refractory disease.
Is polatuzumab vedotin chemotherapy or targeted therapy?
It is targeted treatment called an antibody–drug conjugate. Its antibody targets CD79b and carries the cell-killing compound MMAE into B cells.
Why is polatuzumab vedotin combined with other cancer treatments?
Its licensed roles were studied and authorised as parts of combination treatments rather than as treatment on its own.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.