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POLIVY + bendamustine + a rituximab product (BR) Advance the possibilities in R/R DLBCL, NOS, after at least 2 prior therapies 1 Granted accelerated approval. Additional studies are needed to establish clinical benefi t. NCCN GUIDELINES ® PREFERRED TREATMENT (CATEGORY 2A) 2 NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ® ) recommend polatuzumab vedotin-piiq (POLIVY) + bendamustine + rituximab (BR) as a preferred treatment option, after at least 2 prior therapies, for patients with relapsed or refractory diffuse large B-cell lymphoma who are not candidates for transplant (Category 2A). 2 * *See the NCCN Guidelines for detailed recommendations. The National Comprehensive Cancer Network ® (NCCN ® ) makes no warranties of any kind whatsoever regarding their content, use, or application and disclaims any responsibility for their application or use in any way. R/R=relapsed or refractory; DLBCL=diffuse large B-cell lymphoma; NOS=not otherwise specifi ed. Indication POLIVY in combination with bendamustine and a rituximab product is indicated for the treatment of adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), not otherwise specifi ed, after at least 2 prior therapies. Accelerated approval was granted for this indication based on complete response rate. Continued approval for this indication may be contingent upon verifi cation and description of clinical benefi t in a confi rmatory trial. Important Safety Information Peripheral Neuropathy POLIVY can cause peripheral neuropathy, including severe cases. Peripheral neuropathy occurs as early as the fi rst cycle of treatment and is cumulative. POLIVY may exacerbate preexisting peripheral neuropathy. In Study GO29365, of 173 patients treated with POLIVY, 40% reported new or worsening peripheral neuropathy, with a median time to onset of 2.1 months. Monitor for symptoms of peripheral neuropathy. Patients experiencing new or worsening peripheral neuropathy may require a delay, dose reduction, or discontinuation of POLIVY. Infusion-Related Reactions POLIVY can cause infusion-related reactions, including severe cases. Delayed infusion-related reactions as late as 24 hours after receiving POLIVY have occurred. With premedication, 7% of patients (12/173) in Study GO29365 reported infusion-related reactions after administration of POLIVY. Administer an antihistamine and an antipyretic prior to the administration of POLIVY, and monitor patients closely throughout the infusion. If an infusion-related reaction occurs, slow or interrupt the infusion and institute appropriate medical management. Myelosuppression Treatment with POLIVY can cause serious or severe myelosuppression, including neutropenia, thrombocytopenia, and anemia. In patients treated with POLIVY plus bendamustine and a rituximab product (BR) (n=45), 42% received primary prophylaxis with granulocyte colony-stimulating factor. Cytopenias were the most common reason for treatment discontinuation (18% of all patients). Monitor complete blood counts throughout treatment. Cytopenias may require a delay, dose reduction, or discontinuation of POLIVY. Consider prophylactic granulocyte colony-stimulating factor administration. Serious and Opportunistic Infections Fatal and/or serious infections, including opportunistic infections such as sepsis, pneumonia (including Pneumocystis jiroveci and other fungal pneumonia), herpesvirus infection, and cytomegalovirus infection have occurred in patients treated with POLIVY. Grade 3 or higher infections occurred in 32% (55/173) of patients treated with POLIVY. Infection-related deaths were reported in 2.9% of patients within 90 days of last treatment. Closely monitor patients during treatment for signs of infection. Administer prophylaxis for Pneumocystis jiroveci pneumonia and herpesvirus. Progressive Multifocal Leukoencephalopathy (PML) PML has been reported after treatment with POLIVY (0.6%, 1/173). Monitor for new or worsening neurological, cognitive, or behavioral changes. Hold POLIVY and any concomitant chemotherapy if PML is suspected, and permanently discontinue if the diagnosis is confirmed. Tumor Lysis Syndrome (TLS) POLIVY may cause TLS. Patients with high tumor burden and rapidly proliferating tumors may be at increased risk of TLS. Monitor closely and take appropriate measures, including TLS prophylaxis.