POLIVY was added to the CDL to improve access for DLBCL patients, making it eligible for coverage under MediShield Life, MediSave and Integrated Shield Plans for Singapore Citizens and Permanent Residents
Lymphoma is one of the most common cancers in Singapore and an estimated 300 people are diagnosed with diffuse large B-cell lymphoma (DLBCL) each year; up to 40% of patients worldwide relapse or are refractory to the current standard of care
A recent Singapore Expert Opinion Paper recommended the use of POLIVY in intermediate to high-risk patients but noted that cost constraints could be a limiting factor
POLIVY® (polatuzumab vedotin) has been added to the Singapore Ministry of Health’s Cancer Drug List (CDL), making it eligible for coverage for Singapore Citizens and Permanent Residents under Singapore’s MediShield Life, MediSave and Integrated Shield Plans. Under the CDL, POLIVY is now covered for use in previously untreated diffuse large B-cell lymphoma (DLBCL) in combination with rituximab, cyclophosphamide, doxorubicin and prednisone. It is also eligible for subsidy under the Medication Assistance Fund (MAF) for certain groups of patients.1
Lymphomas are a group of blood cancers that cause enlargement of the lymph nodes, liver and spleen. They are the fourth and fifth most common incident cancers in males and females in Singapore, respectively.2 Worldwide, the most common form of lymphoma is DLBCL, a type of fast-growing non-Hodgkin's lymphoma.3 In Singapore, approximately 300 patients are diagnosed with DLBCL each year, accounting for almost half of all new non-Hodgkin’s lymphoma cases here.1
POLIVY’s addition to the CDL comes at a time when access to improved first-line treatment strategies for DLBCL are urgently needed. At present, approximately 30-40% of DLBCL patients worldwide who receive R-CHOP treatment regimens — the standard of care for the past 20 years — experience relapse or are refractory to the initial treatment.4 Despite numerous efforts over the last two decades, limited progress has been made in improving first-line patient outcomes.5 Against this backdrop, the POLARIX trial demonstrated that the addition of POLIVY to a modified R-CHOP for first-line treatment of DLBCL resulted in 27% lower risk of disease progression, relapse, or death compared to those who received R-CHOP alone after 2 years (stratified hazard ratio of 0.73 by Cox regression; 95% CI, 0.57 to 0.95; P=0.02).6 Based on these results, a recent review of the DLBCL treatment landscape in Singapore recommended the use of POLIVY in intermediate to high-risk patients but noted that cost constraints could be a limiting factor.5
About POLIVY® (polatuzumab vedotin)
Polatuzumab vedotin is a first-in-class CD79b-targeted antibody-drug conjugate that preferentially delivers an anti-mitotic agent (monomethyl auristatin E, or MMAE) to B-cells, which results in the killing of malignant B-cells. The monoclonal antibody binds to CD79b, a cell surface component of the B-cell receptor. CD79b expression is restricted to normal cells within the B cell lineage (with the exception of plasma cells) and malignant B-cells; it is expressed in >95% of DLBCL. Upon binding CD79b, polatuzumab vedotin is rapidly internalized, aiding in the delivery of MMAE intracellularly. MMAE then works to kill dividing cells by inhibiting cell division and inducing apoptosis. In Singapore, POLIVY is approved in combination with rituximab, cyclophosphamide, doxorubicin, and prednisone (R-CHP) for the treatment of adult patients with previously untreated DLBCL. It is also approved in combination with bendamustine and MabThera for the treatment of adult patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL) who are not eligible for haematopoietic cell transplant.
About diffuse large B-cell lymphoma (DLBCL)
Lymphomas are the fourth and fifth most common cancers in Singapore in males and females, respectively.2 In Singapore, non-Hodgkin lymphomas (NHL) account for around 90% of all lymphoma cases.7 DLBCL is the most common form of non-Hodgkin’s lymphoma NHL, accounting for about one in three cases of NHL. DLBCL is an aggressive (fast-growing) type of NHL, which is generally responsive to treatment in the frontline. However, as many as 40 percent of patients will relapse, at which time salvage therapy options are limited and survival is short. In Singapore, it is estimated that around 300 new cases of DLBCL are diagnosed each year.
About Roche Singapore
Founded in 1896 in Basel, Switzerland, as one of the first industrial manufacturers of branded medicines, Roche has grown into the world’s largest biotechnology company and the global leader in in-vitro diagnostics. The company pursues scientific excellence to discover and develop medicines and diagnostics for improving and saving the lives of people around the world. We are a pioneer in personalised healthcare and want to further transform how healthcare is delivered to have an even greater impact. To provide the best care for each person we partner with many stakeholders and combine our strengths in Diagnostics and Pharma with data insights from the clinical practice.
Roche Singapore started operations in 1973 and has grown over 50 years into a local leader in innovative medicines and diagnostics across multiple disease areas. Today, Roche Singapore employs more than 1,000 people across its pharmaceuticals, diagnostics and manufacturing divisions.
For more information, please visit www.roche.com.sg.
References
Technology Guidance: Polatuzumab vedotin for previously untreated diffuse large B-cell lymphoma, 2024. Agency for Care Effectiveness, Ministry of Health, Singapore.
Singapore Cancer Registry Annual Report 2021: Cancer in Singapore 2017-2021 . Health Promotion Board, 2023.
Lymphoma - non-Hodgkin - subtypes. [Online] Cancer.Net. Available from: https://www.cancer.net/cancer-types/lymphoma-non-hodgkin/subtypes [Accessed: 27th January 2024]
Poletto S, Novo M, Paruzzo L, Frascione PM, Vitolo U. Treatment strategies for patients with diffuse large B-cell lymphoma. Cancer Treatment Reviews. [Online] 2022;110: 102443. Available from: doi:10.1016/j.ctrv.2022.102443
Chan JY, Somasundaram N, Grigoropoulos N, Lim F, Poon ML, Jeyasekharan A, Yeoh KW, Tan D, Lenz G, Ong CK, Lim ST. Evolving therapeutic landscape of diffuse large B-cell lymphoma: challenges and aspirations. Discov Oncol. 2023 Jul 19;14(1):132. doi: 10.1007/s12672-023-00754-8. PMID: 37466782; PMCID: PMC10361453
Tilly H, Morschhauser F, Sehn LH, Friedberg JW, Trněný M, Sharman JP, et al. Polatuzumab vedotin in previously untreated diffuse large B-cell lymphoma. New England Journal of Medicine. [Online] 2022;386(4): 351–363. Available from: doi:10.1056/nejmoa2115304
Lymphoma. [Online] SingHealth. Available from: https://www.singhealth.com.sg/patient-care/conditions-treatments/lymphoma [Accessed: 27th January 2024]
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