{"entity":{"id":"polar-bear","kind":"trial","name":"POLAR BEAR","aka":["POLAR BEAR trial","R-pola-miniCHP in very old patients"],"tldr":"A Nordic trial asking whether the antibody-drug conjugate that improved first-line treatment for younger patients also helps people in their eighties, who were barely represented in the original trial.","summary":"POLARIX established polatuzumab vedotin in place of vincristine in first-line diffuse large B-cell lymphoma, but it enrolled patients up to 80 and the very old and frail were scarcely represented. The standard for that group is R-miniCHOP, a dose-reduced regimen built for tolerability rather than cure. POLAR BEAR asks the same substitution question in exactly the population POLARIX did not answer for.\n\nEligibility is deliberately narrow and unusual: 80 years or older, or 75 or older and frail by a simplified comprehensive geriatric assessment. Participants are randomised 1 to 1 between R-miniCHOP and R-pola-miniCHP. Both arms run 18 weeks, with follow-up to 36 months after treatment ends. The primary endpoint is progression-free survival, and primary completion is estimated for 28 December 2025, so the first report is close.\n\nSites are open in Sweden, Norway, Finland, Denmark, Italy, Australia and New Zealand. Using a geriatric assessment as an eligibility criterion, rather than age alone, is the methodological contribution: it is the kind of trial design that the gap between trial populations and real lymphoma patients has been waiting for.","status":"active","asOf":"2026-10-01","links":[{"label":"ClinicalTrials.gov NCT04332822","url":"https://clinicaltrials.gov/study/NCT04332822"}],"tags":["lymphoma-evidence"],"related":[],"cancers":["dlbcl","non-hodgkin-lymphoma"],"sections":["adcs","chemotherapy"],"technologies":["adc"],"targets":["cd79b","cd20"],"drugs":["polatuzumab-vedotin","rituximab","cyclophosphamide","doxorubicin","vincristine","prednisone"],"companies":[],"institutions":[],"pathways":[],"terms":["r-chop","lymphoma-tx-regimen-alphabet"],"trials":["polarix","arched"],"people":[],"bottlenecks":["b-aging-comorbidity","b-trial-diversity","b-trial-enrolment"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT04332822","phase":"3","setting":"Aged 80 or over, or 75 or over and frail, with untreated diffuse large B-cell lymphoma: R-miniCHOP against R-pola-miniCHP, which replaces the vincristine with polatuzumab vedotin","sponsor":"Nordic Lymphoma Group","started":"2020-08-19","startedType":"actual","enrolled":300,"enrolledBasis":"registry","outcomes":[]},"route":"/trials/polar-bear/","neighbours":{"cancer":[{"id":"dlbcl","kind":"cancer","name":"Diffuse large B-cell lymphoma","route":"/cancers/dlbcl/"},{"id":"non-hodgkin-lymphoma","kind":"cancer","name":"Non-Hodgkin lymphoma (all types)","route":"/cancers/non-hodgkin-lymphoma/"}],"section":[{"id":"adcs","kind":"section","name":"Antibody-Drug Conjugates","route":"/fronts/adcs/"},{"id":"chemotherapy","kind":"section","name":"Chemotherapy","route":"/fronts/chemotherapy/"}],"technology":[{"id":"adc","kind":"technology","name":"Antibody-drug conjugate (ADC)","route":"/technologies/adc/"}],"target":[{"id":"cd20","kind":"target","name":"CD20","route":"/targets/cd20/"},{"id":"cd79b","kind":"target","name":"CD79b","route":"/targets/cd79b/"}],"drug":[{"id":"cyclophosphamide","kind":"drug","name":"Cyclophosphamide","route":"/drugs/cyclophosphamide/"},{"id":"doxorubicin","kind":"drug","name":"Doxorubicin","route":"/drugs/doxorubicin/"},{"id":"polatuzumab-vedotin","kind":"drug","name":"Polatuzumab vedotin","route":"/drugs/polatuzumab-vedotin/"},{"id":"prednisone","kind":"drug","name":"Prednisone","route":"/drugs/prednisone/"},{"id":"rituximab","kind":"drug","name":"Rituximab","route":"/drugs/rituximab/"},{"id":"vincristine","kind":"drug","name":"Vincristine","route":"/drugs/vincristine/"}],"term":[{"id":"r-chop","kind":"term","name":"R-CHOP (lymphoma chemoimmunotherapy)","route":"/terms/r-chop/"},{"id":"lymphoma-tx-regimen-alphabet","kind":"term","name":"The lymphoma regimen alphabet: R-CHOP, pola-R-CHP, DA-EPOCH-R, ABVD, BEACOPP and the rest","route":"/terms/lymphoma-tx-regimen-alphabet/"}],"trial":[{"id":"arched","kind":"trial","name":"ARCHED","route":"/trials/arched/"},{"id":"polarix","kind":"trial","name":"POLARIX","route":"/trials/polarix/"}],"bottleneck":[{"id":"b-aging-comorbidity","kind":"bottleneck","name":"Older and multimorbid patients are excluded and undertreated","route":"/bottlenecks/b-aging-comorbidity/"},{"id":"b-trial-diversity","kind":"bottleneck","name":"Trials do not represent the people who get cancer","route":"/bottlenecks/b-trial-diversity/"},{"id":"b-trial-enrolment","kind":"bottleneck","name":"Trials enrol too few, too slowly","route":"/bottlenecks/b-trial-enrolment/"}],"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/"}],"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/"}]}}