{"entity":{"id":"polarix","kind":"trial","name":"POLARIX","aka":[],"tldr":"The trial that improved on R-CHOP for the first time in twenty years, by swapping vincristine for an ADC.","summary":"POLARIX, trial NCT03274492 sponsored by Roche and published in the New England Journal of Medicine in 2022, was the trial that improved on R-CHOP in untreated diffuse large B-cell lymphoma for the first time in twenty years, by swapping vincristine for the CD79b antibody-drug conjugate polatuzumab vedotin. It randomised 879 patients aged 18 to 80 with IPI 2 to 5 to Pola-R-CHP or R-CHOP, met its primary progression-free survival endpoint at two years with the benefit holding at five years in the 2025 JCO update, while overall survival was not significantly different and safety was similar; benefit concentrated in ABC-type and higher IPI disease. Whether a progression benefit without a survival benefit justifies the regimen for every patient is the open question.","status":"positive","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT03274492","url":"https://clinicaltrials.gov/study/NCT03274492"},{"label":"NEJM 2022","url":"https://www.nejm.org/doi/full/10.1056/NEJMoa2115304"},{"label":"5-year JCO 2025","url":"https://ascopubs.org/doi/10.1200/JCO-25-00925"}],"tags":[],"related":["lymphoma-roadmap","polargo","polar-bear","flyer","goya"],"cancers":["dlbcl"],"sections":[],"technologies":["adc"],"targets":[],"drugs":["polatuzumab-vedotin","doxorubicin"],"companies":["lysa"],"institutions":[],"pathways":[],"terms":["pfs","ipi-score"],"trials":[],"people":["gilles-salles","herve-tilly","laurie-sehn"],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT03274492","phase":"3","setting":"Untreated DLBCL, IPI 2-5, age 18-80: Pola-R-CHP vs R-CHOP","sponsor":"Roche","result":"2-year PFS 76.7% vs 70.2%, HR 0.73; 5-year OS HR 0.85 (NS).","started":"2017-11-16","startedType":"actual","yearReported":2021,"enrolled":879,"enrolledBasis":"randomised","enrolledNote":"ClinicalTrials.gov lists 1,000 participants (actual); the NEJM 2022 primary analysis randomised 879 patients (440 Pola-R-CHP, 439 R-CHOP).","outcomes":[{"endpoint":"Progression-free survival at 2 years","primary":true,"unit":"%","arms":[{"name":"Pola-R-CHP","n":440,"value":76.7},{"name":"R-CHOP","n":439,"value":70.2}],"hr":0.73,"ci":[0.57,0.95],"p":"0.02","source":"https://www.nejm.org/doi/full/10.1056/NEJMoa2115304"},{"endpoint":"Progression-free survival at 5 years","unit":"%","arms":[{"name":"Pola-R-CHP","value":64.9},{"name":"R-CHOP","value":59.1}],"hr":0.77,"ci":[0.62,0.97],"source":"https://ascopubs.org/doi/10.1200/JCO-25-00925"},{"endpoint":"Overall survival at 5 years","unit":"%","arms":[{"name":"Pola-R-CHP","value":82.3},{"name":"R-CHOP","value":79.5}],"hr":0.85,"ci":[0.63,1.15],"source":"https://ascopubs.org/doi/10.1200/JCO-25-00925"}],"replication":"Consistent with the phase 1b/2 GO29044 cohort; POLAR BEAR (elderly) and real-world series broadly concordant; no OS benefit at 5 years."},"route":"/trials/polarix/","neighbours":{"roadmap":[{"id":"chemotherapy-roadmap","kind":"roadmap","name":"Chemotherapy roadmap: mustard gas → curative combinations → the warhead inside smarter drugs","route":"/roadmaps/chemotherapy-roadmap/"},{"id":"lymphoma-roadmap","kind":"roadmap","name":"Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting","route":"/roadmaps/lymphoma-roadmap/"}],"trial":[{"id":"flyer","kind":"trial","name":"FLYER","route":"/trials/flyer/"},{"id":"goya","kind":"trial","name":"GOYA","route":"/trials/goya/"},{"id":"polar-bear","kind":"trial","name":"POLAR BEAR","route":"/trials/polar-bear/"},{"id":"polargo","kind":"trial","name":"POLARGO","route":"/trials/polargo/"}],"cancer":[{"id":"dlbcl","kind":"cancer","name":"Diffuse large B-cell lymphoma","route":"/cancers/dlbcl/"},{"id":"follicular-lymphoma","kind":"cancer","name":"Follicular lymphoma","route":"/cancers/follicular-lymphoma/"},{"id":"non-hodgkin-lymphoma","kind":"cancer","name":"Non-Hodgkin lymphoma (all types)","route":"/cancers/non-hodgkin-lymphoma/"}],"technology":[{"id":"adc","kind":"technology","name":"Antibody-drug conjugate (ADC)","route":"/technologies/adc/"}],"drug":[{"id":"doxorubicin","kind":"drug","name":"Doxorubicin","route":"/drugs/doxorubicin/"},{"id":"polatuzumab-vedotin","kind":"drug","name":"Polatuzumab vedotin","route":"/drugs/polatuzumab-vedotin/"}],"company":[{"id":"lysa","kind":"company","name":"LYSA (The Lymphoma Study Association)","route":"/companies/lysa/"}],"term":[{"id":"lymphoma-tx-uk-versus-us","kind":"term","name":"British and American lymphoma practice: where they differ, and why","route":"/terms/lymphoma-tx-uk-versus-us/"},{"id":"ipi-score","kind":"term","name":"International Prognostic Index (IPI)","route":"/terms/ipi-score/"},{"id":"pfs","kind":"term","name":"Progression-free survival (PFS)","route":"/terms/pfs/"}],"person":[{"id":"gilles-salles","kind":"person","name":"Gilles Salles","route":"/people/gilles-salles/"},{"id":"herve-tilly","kind":"person","name":"Hervé Tilly","route":"/people/herve-tilly/"},{"id":"laurie-sehn","kind":"person","name":"Laurie H. Sehn","route":"/people/laurie-sehn/"}],"paper":[{"id":"paper-polarix-polatuzumab-rchp-nejm-2022","kind":"paper","name":"POLARIX: swapping vincristine for the antibody-drug conjugate polatuzumab vedotin in first-line treatment of diffuse large B-cell lymphoma","route":"/key-papers/paper-polarix-polatuzumab-rchp-nejm-2022/"},{"id":"paper-polargo-polatuzumab-r-gemox-dlbcl-jco-2026","kind":"paper","name":"Polatuzumab vedotin plus rituximab, gemcitabine, and oxaliplatin in relapsed or refractory diffuse large B-cell lymphoma: results from the phase III, randomized POLARGO trial","route":"/key-papers/paper-polargo-polatuzumab-r-gemox-dlbcl-jco-2026/"}]}}