Phase III POLAR BEAR trial: Pola-R-mini-CHP vs R-mini-CHOP in elderly or frail patients with DLBCL

Results from the phase III POLAR BEAR (NCT04332822) trial, evaluating polatuzumab vedotin + rituximab + cyclophosphamide + doxorubicin + prednisolone (Pola-R-mini-CHP; n = 150) vs rituximab + cyclophosphamide + doxorubicin + vincristine + prednisolone (R-mini-CHOP; n = 150) in elderly patients (aged ≥80 years), or frail patients aged 75–80 years, with diffuse large B-cell lymphoma (DLBCL), were presented by Mats Jerkeman at the European Hematology Association (EHA) 2026 Congress, June 11–14, 2026, Stockholm, SE. The primary endpoint was progression-free survival (PFS).

Key data: At a median follow-up of 2.54 years, the pooled 2-year PFS and OS were 63% (95% confidence interval [CI], 57–69) and 76% (95% CI, 70–80), respectively. Age, comorbidities, Instrumental Activities of Daily Life (IADL), and Activities of Daily Life (ADL) had no clear prognostic impact on PFS. Pola-R-mini-CHP was associated with greater rates of Grade ≥3 infection (16.7% vs 10.7%), gastrointestinal (GI; 8% vs 3.3%), and cardiovascular (8% vs 3.3%) adverse events (AEs). Serious AEs (SAEs) occurred in 42.7% vs 36% of patients receiving Pola-R-mini-CHP vs R-mini-CHOP, including fatal SAEs in 7.3% vs 2.7% of patients. 

Key learning: Both Pola-R-mini-CHP and R-mini-CHOP were tolerable in elderly or frail patients with DLBCL, though Pola-R-mini-CHP was associated with greater rates of Grade ≥3 infections, GI, and cardiovascular AEs. Early pooled efficacy data are encouraging, with outcomes per treatment arm expected in 2027.