# Polatuzumab vedotin plus rituximab, gemcitabine, and oxaliplatin in relapsed or refractory diffuse large B-cell lymphoma: results from the phase III, randomized POLARGO trial

Source: https://onco.cc/key-papers/paper-polargo-polatuzumab-r-gemox-dlbcl-jco-2026/  
OnCo record `paper-polargo-polatuzumab-r-gemox-dlbcl-jco-2026` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Adding an antibody-drug conjugate to an outpatient chemotherapy pairing added seven months of median survival for people with relapsed aggressive lymphoma who could not have a transplant.

## Summary

A randomised, open-label, global phase 3 trial. After a 15-patient safety run-in, 255 patients with relapsed or refractory diffuse large B-cell lymphoma, not otherwise specified or transformed from an indolent lymphoma, who were ineligible for autologous stem-cell transplantation, were randomised 1 to 1 to polatuzumab vedotin with rituximab, gemcitabine and oxaliplatin (129) or to rituximab, gemcitabine and oxaliplatin alone (126), every 21 days for up to eight cycles. Overall survival was the primary endpoint.

After a median follow-up of 24.6 months, the hazard ratio for death was 0.6 (95 per cent confidence interval 0.43 to 0.83, p = 0.0017), with median overall survival 19.5 months (13.3 to not estimable) against 12.5 months (8.9 to 15.8). The commonest grade 3 or 4 adverse events were thrombocytopenia and neutropenia. Peripheral neuropathy occurred in 73 patients (57 per cent) on the polatuzumab arm against 36 (29 per cent), and was primarily grade 1. Fatal adverse events occurred in 15 patients (12 per cent) against five (4 per cent), largely driven by infections including COVID-19.

## Fields

- Kind: Key paper
- Last checked: 2026-10-01
- Also known as: POLARGO; Matasar 2026; Pola-R-GemOx
- Tags: lymphoma-evidence
- Journal: Journal of Clinical Oncology
- Year: 2026
- DOI: 10.1200/JCO-25-02849
- Authors: Matasar M, Li Z, Vassilakopoulos TP, et al.
- Findings: Median overall survival was 19.5 months with polatuzumab vedotin added to rituximab, gemcitabine and oxaliplatin against 12.5 months without (hazard ratio 0.6, 95 per cent confidence interval 0.43 to 0.83, p = 0.0017).; Overall survival was the primary endpoint, not a secondary one.; Peripheral neuropathy occurred in 57 per cent of the polatuzumab group against 29 per cent, primarily grade 1.; Fatal adverse events occurred in 12 per cent against 4 per cent, largely driven by infections including COVID-19.
- What it means: An option with a demonstrated survival benefit for transplant-ineligible relapsed diffuse large B-cell lymphoma, a group for whom very little has ever shown one. The fatal adverse event imbalance belongs in the conversation alongside the survival figure.
- Caveats: Open-label, so supportive care and subsequent therapy were not blinded.; Recruitment ran through the COVID-19 pandemic, which contributed to the fatal infection imbalance and makes it hard to read.; Patients who could receive CAR-T or a bispecific antibody may be better served by those, and the trial does not compare against them.

## Sources

- Journal of Clinical Oncology 2026: https://doi.org/10.1200/JCO-25-02849
- PubMed: https://pubmed.ncbi.nlm.nih.gov/42407012/
- Europe PMC: https://europepmc.org/article/MED/42407012

## Connected records

- roadmaps: [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](https://onco.cc/roadmaps/lymphoma-roadmap/)
- cancers: [Diffuse large B-cell lymphoma](https://onco.cc/cancers/dlbcl/), [Non-Hodgkin lymphoma (all types)](https://onco.cc/cancers/non-hodgkin-lymphoma/)
- fronts: [Antibody-Drug Conjugates](https://onco.cc/fronts/adcs/), [Chemotherapy](https://onco.cc/fronts/chemotherapy/)
- technologies: [Antibody-drug conjugate (ADC)](https://onco.cc/technologies/adc/)
- targets: [CD20](https://onco.cc/targets/cd20/), [CD79b](https://onco.cc/targets/cd79b/)
- drugs: [Gemcitabine](https://onco.cc/drugs/gemcitabine/), [Oxaliplatin](https://onco.cc/drugs/oxaliplatin/), [Polatuzumab vedotin](https://onco.cc/drugs/polatuzumab-vedotin/), [Rituximab](https://onco.cc/drugs/rituximab/)
- companies: [Roche / Genentech](https://onco.cc/companies/roche-genentech/)
- trials: [POLARGO](https://onco.cc/trials/polargo/), [POLARIX](https://onco.cc/trials/polarix/)
- bottlenecks: [Older and multimorbid patients are excluded and undertreated](https://onco.cc/bottlenecks/b-aging-comorbidity/), [Toxicity and quality of life are undervalued](https://onco.cc/bottlenecks/b-toxicity-qol/)
- journals: [Journal of Clinical Oncology](https://onco.cc/journals/jco/)
- key papers: [POLARIX: swapping vincristine for the antibody-drug conjugate polatuzumab vedotin in first-line treatment of diffuse large B-cell lymphoma](https://onco.cc/key-papers/paper-polarix-polatuzumab-rchp-nejm-2022/)

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