Most Common Adverse Reactions to Polivy
Polivy (polatuzumab vedotin-piiq), used with bendamustine and rituximab for relapsed or refractory diffuse large B-cell lymphoma, has these most reported adverse reactions from clinical trials, occurring in 20% or more of patients:
- Neutropenia (41%)
- Thrombocytopenia (36%)
- Anemia (36%)
- Peripheral neuropathy (25%)
- Fatigue (24%)
- Diarrhea (23%)
- Pyrexia (21%)
These rates come from the phase 2 GO29365 trial (N=80), where Polivy was combined with BR.[1][2]
Grade 3-4 Severe Reactions
Serious reactions (grade 3 or higher) were frequent, including:
- Neutropenia (41%)
- Thrombocytopenia (23%)
- Anemia (14%)
Nearly all patients (96%) experienced at least one adverse reaction, with 70% facing grade 3-4 events.[1][2]
Reactions Leading to Discontinuation or Death
About 18% discontinued due to adverse reactions, mainly peripheral neuropathy, pneumonia, and thrombocytopenia. Fatal events linked to treatment included pneumonia (3%), sepsis (2%), and others like sudden death or diffusion lung disease (each 1%).[1]
Peripheral Neuropathy Specifics
Peripheral neuropathy affected 44% overall (53% any grade with BR combo), with 40% grade 1-2 and 14% grade 3. It was the top reason for stopping Polivy (14% of cases), often sensory and resolving over time.[1][2]
Infection Risks
Infections hit 89% of patients, with 50% grade 3-4 cases like pneumonia (18%), sepsis (11%), and urinary tract infections (7%). Prophylaxis for Pneumocystis jirovecii and antivirals is recommended.[1]
Comparison to Bendamustine-Rituximab Alone
In trials, Polivy-BR raised rates of cytopenias, neuropathy, and fatigue versus BR alone (e.g., neutropenia 41% vs. 13%; neuropathy 44% vs. 4%).[1]
Sources
[1]: Polivy Prescribing Information (Genentech, 2023)
[2]: Drugs.com - Polivy Side Effects