# POLARIX

Source: https://onco.cc/trials/polarix/  
OnCo record `polarix` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

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.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-07
- Registry id: NCT03274492
- Phase: 3
- Setting: Untreated DLBCL, IPI 2-5, age 18-80: Pola-R-CHP vs R-CHOP
- Sponsor: Roche
- Enrolled: 879
- Result: 2-year PFS 76.7% vs 70.2%, HR 0.73; 5-year OS HR 0.85 (NS).
- Outcomes: Progression-free survival at 2 years: Pola-R-CHP 76.7% vs R-CHOP 70.2%, HR 0.73; Progression-free survival at 5 years: Pola-R-CHP 64.9% vs R-CHOP 59.1%, HR 0.77; Overall survival at 5 years: Pola-R-CHP 82.3% vs R-CHOP 79.5%, HR 0.85
- Replication: Consistent with the phase 1b/2 GO29044 cohort; POLAR BEAR (elderly) and real-world series broadly concordant; no OS benefit at 5 years.

## Sources

- ClinicalTrials.gov NCT03274492: https://clinicaltrials.gov/study/NCT03274492
- NEJM 2022: https://www.nejm.org/doi/full/10.1056/NEJMoa2115304
- 5-year JCO 2025: https://ascopubs.org/doi/10.1200/JCO-25-00925

## Connected records

- roadmaps: [Chemotherapy roadmap: mustard gas → curative combinations → the warhead inside smarter drugs](https://onco.cc/roadmaps/chemotherapy-roadmap/), [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/)
- trials: [FLYER](https://onco.cc/trials/flyer/), [GOYA](https://onco.cc/trials/goya/), [POLAR BEAR](https://onco.cc/trials/polar-bear/), [POLARGO](https://onco.cc/trials/polargo/)
- cancers: [Diffuse large B-cell lymphoma](https://onco.cc/cancers/dlbcl/), [Follicular lymphoma](https://onco.cc/cancers/follicular-lymphoma/), [Non-Hodgkin lymphoma (all types)](https://onco.cc/cancers/non-hodgkin-lymphoma/)
- technologies: [Antibody-drug conjugate (ADC)](https://onco.cc/technologies/adc/)
- drugs: [Doxorubicin](https://onco.cc/drugs/doxorubicin/), [Polatuzumab vedotin](https://onco.cc/drugs/polatuzumab-vedotin/)
- companies: [LYSA (The Lymphoma Study Association)](https://onco.cc/companies/lysa/)
- terms: [British and American lymphoma practice: where they differ, and why](https://onco.cc/terms/lymphoma-tx-uk-versus-us/), [International Prognostic Index (IPI)](https://onco.cc/terms/ipi-score/), [Progression-free survival (PFS)](https://onco.cc/terms/pfs/)
- people: [Gilles Salles](https://onco.cc/people/gilles-salles/), [Hervé Tilly](https://onco.cc/people/herve-tilly/), [Laurie H. Sehn](https://onco.cc/people/laurie-sehn/)
- 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/), [Polatuzumab vedotin plus rituximab, gemcitabine, and oxaliplatin in relapsed or refractory diffuse large B-cell lymphoma: results from the phase III, randomized POLARGO trial](https://onco.cc/key-papers/paper-polargo-polatuzumab-r-gemox-dlbcl-jco-2026/)

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