Polivy

Indications

Polatuzumab Vedotin is a cancer medicine used to treat diffuse large B-cell lymphoma (DLBCL), a fast-growing cancer of the lymphatic system. It is used together with other cancer medicines, either as first treatment or when the lymphoma has come back or has not responded to earlier treatment.

How It Works

It is an antibody-drug conjugate: an antibody joined to a strong cell-killing drug. The antibody part finds and attaches to a protein called CD79b, found on the surface of B-cells, including lymphoma cells. Once inside the cell, the drug part (monomethyl auristatin E) is released and stops the cell from dividing, so the cancer cell dies. This targets the drug mainly to the lymphoma cells.

Dosage and Administration

It is given as a drip (intravenous infusion) into a vein by a doctor or nurse in hospital or a cancer centre, usually once every 3 weeks for a set number of cycles, together with other medicines. The dose is calculated from body weight and set by the cancer specialist. Medicines to prevent infusion reactions may be given beforehand. Use only as prescribed.

Interactions

Strong CYP3A4 inhibitors (such as Ketoconazole or Clarithromycin) may increase exposure to the cell-killing part and raise the risk of side effects, while strong inducers (such as Rifampicin) may lower it. Live vaccines should be avoided during treatment. Tell your doctor about all medicines, herbal products and vaccines.

Contraindications

• Allergy to Polatuzumab Vedotin or any ingredient
• Active severe infection

Side Effects

Common side effects include nerve damage in the hands and feet (numbness, tingling, burning or weakness), low blood counts (neutrophils, platelets, red cells), infections such as pneumonia, tiredness, fever, diarrhoea, nausea, reduced appetite and hair loss. Infusion reactions, liver problems and tumour lysis syndrome (a chemical imbalance from rapid breakdown of cancer cells) can occur. A rare brain infection called progressive multifocal leukoencephalopathy (PML) has been reported.

Get urgent medical help if you have fever or chills, signs of infection, unusual bleeding or bruising, shortness of breath, swelling of the face or throat during or after the infusion, yellowing of the skin or eyes, or new confusion, memory loss, vision changes, trouble speaking or walking.

Pregnancy and Lactation

It can harm an unborn baby and must not be used in pregnancy. Women who can become pregnant and men with a partner who can become pregnant must use effective contraception during treatment and for several months after the last dose, as advised by the doctor. Do not breastfeed during treatment and for some months afterwards. It may affect fertility.

Precautions and Warnings

Blood counts, liver function and signs of nerve damage are checked regularly, and doses may be delayed or reduced. Preventive medicines against infections may be given. Report any numbness or tingling early. Nerve problems or tiredness may affect driving.

Overdose

There is no specific antidote. The hospital team will monitor closely and give supportive care if too much is given.

Therapeutic Class

Antineoplastic agent, antibody-drug conjugate (anti-CD79b)

Storage

Hospital medicine: store as directed on the pack, usually in a refrigerator at 2 to 8°C, do not freeze, protect from light. Keep out of the reach of children.