{"entity":{"id":"polargo","kind":"trial","name":"POLARGO","aka":["Pola-R-GemOx","POLARGO trial"],"tldr":"Adding an antibody-drug conjugate to a gentle outpatient chemotherapy pairing added about seven months of life for people with relapsed aggressive lymphoma who could not have a transplant.","summary":"Rituximab with gemcitabine and oxaliplatin is the regimen offered when someone with relapsed diffuse large B-cell lymphoma cannot tolerate transplant-intensity salvage, and its results have always been modest. POLARGO added polatuzumab vedotin, the CD79b antibody-drug conjugate already established in the first line by POLARIX.\n\nAfter a 15-patient safety run-in, 255 patients with relapsed or refractory disease (not otherwise specified, or transformed from an indolent lymphoma) who were ineligible for autologous transplant were randomised to polatuzumab with rituximab, gemcitabine and oxaliplatin (129) or to the chemotherapy alone (126), for up to eight 21-day cycles. Overall survival was the primary endpoint, which is unusual and makes the result harder to dismiss. At 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 against 12.5.\n\nThe cost is real: peripheral neuropathy in 57 per cent against 29 per cent, mostly grade 1, and fatal adverse events in 12 per cent against 4 per cent, largely infections including COVID-19. The trial recruited through the pandemic, which bears on that figure.","status":"positive","asOf":"2026-10-01","links":[{"label":"ClinicalTrials.gov NCT04182204","url":"https://clinicaltrials.gov/study/NCT04182204"},{"label":"Journal of Clinical Oncology 2026","url":"https://doi.org/10.1200/JCO-25-02849"}],"tags":["lymphoma-evidence"],"related":[],"cancers":["dlbcl","non-hodgkin-lymphoma"],"sections":["adcs","chemotherapy"],"technologies":["adc","monoclonal-antibody"],"targets":["cd79b","cd20"],"drugs":["polatuzumab-vedotin","rituximab","gemcitabine","oxaliplatin"],"companies":["roche-genentech"],"institutions":[],"pathways":[],"terms":["lymphoma-tx-transplant-role"],"trials":["polarix","starglo","sunmo"],"people":[],"bottlenecks":["b-toxicity-qol","b-aging-comorbidity"],"keyPapers":["paper-polargo-polatuzumab-r-gemox-dlbcl-jco-2026"],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT04182204","phase":"3","setting":"Relapsed or refractory diffuse large B-cell lymphoma not eligible for an autologous transplant: polatuzumab vedotin added to rituximab, gemcitabine and oxaliplatin","sponsor":"Hoffmann-La Roche","result":"Median overall survival 19.5 against 12.5 months (hazard ratio 0.6, p = 0.0017), with more peripheral neuropathy and more fatal infections.","started":"2020-02-07","startedType":"actual","yearReported":2026,"enrolled":255,"enrolledBasis":"randomised","enrolledNote":"The registry records 270, which includes the 15-patient safety run-in; 255 were randomised and analysed.","outcomes":[{"endpoint":"Overall survival (median)","primary":true,"unit":"months","arms":[{"name":"Polatuzumab with R-GemOx","n":129,"value":19.5},{"name":"R-GemOx","n":126,"value":12.5}],"hr":0.6,"ci":[0.43,0.83],"p":"0.0017","source":"https://doi.org/10.1200/JCO-25-02849"}],"replication":"Consistent in direction with STARGLO and SUNMO, which added a different class of drug to the same chemotherapy backbone in the same population."},"route":"/trials/polargo/","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/"},{"id":"monoclonal-antibody","kind":"technology","name":"Monoclonal antibodies","route":"/technologies/monoclonal-antibody/"}],"target":[{"id":"cd20","kind":"target","name":"CD20","route":"/targets/cd20/"},{"id":"cd79b","kind":"target","name":"CD79b","route":"/targets/cd79b/"}],"drug":[{"id":"gemcitabine","kind":"drug","name":"Gemcitabine","route":"/drugs/gemcitabine/"},{"id":"oxaliplatin","kind":"drug","name":"Oxaliplatin","route":"/drugs/oxaliplatin/"},{"id":"polatuzumab-vedotin","kind":"drug","name":"Polatuzumab vedotin","route":"/drugs/polatuzumab-vedotin/"},{"id":"rituximab","kind":"drug","name":"Rituximab","route":"/drugs/rituximab/"}],"company":[{"id":"roche-genentech","kind":"company","name":"Roche / Genentech","route":"/companies/roche-genentech/"}],"term":[{"id":"lymphoma-tx-transplant-role","kind":"term","name":"Stem cell transplant in lymphoma: what it is still for","route":"/terms/lymphoma-tx-transplant-role/"}],"trial":[{"id":"nct04404283","kind":"trial","name":"Brentuximab Vedotin Plus Lenalidomide and Rituximab for the Treatment of Relapsed/Refractory DLBCL","route":"/trials/nct04404283/"},{"id":"epcore-nhl-1","kind":"trial","name":"EPCORE NHL-1","route":"/trials/epcore-nhl-1/"},{"id":"polarix","kind":"trial","name":"POLARIX","route":"/trials/polarix/"},{"id":"starglo","kind":"trial","name":"STARGLO","route":"/trials/starglo/"},{"id":"sunmo","kind":"trial","name":"SUNMO","route":"/trials/sunmo/"}],"bottleneck":[{"id":"b-aging-comorbidity","kind":"bottleneck","name":"Older and multimorbid patients are excluded and undertreated","route":"/bottlenecks/b-aging-comorbidity/"},{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}],"paper":[{"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/"}],"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/"}]}}