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Sancho JM, Sorigué M, Rubio-Azpeitia E. Real-World Evidence of Relapsed/Refractory Mantle Cell Lymphoma Patients and Treatments: A Systematic Review. J Blood Med 2024; 15:239-254. [PMID: 38812568 PMCID: PMC11135533 DOI: 10.2147/jbm.s463946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 05/18/2024] [Indexed: 05/31/2024] Open
Abstract
Introduction Mantle cell lymphoma (MCL) is an incurable disease with an aggressive clinical course, and most patients eventually relapse after chemotherapy. Targeted therapies developed for relapsed/refractory MCL have been approved based on clinical trial data. However, real-world setting data are scarce and scattered. Areas Covered This systematic review aimed to collect, synthesize, and describe the characteristics and treatment outcomes of patients with relapsed/refractory MCL after receiving a second or subsequent line of therapy in the real-world setting. Expert Opinion R/R MCL is clinically and biologically heterogeneous and still represents a therapeutic challenge, with high-risk and early relapsed patients remaining an unmet medical need. This systematic review is limited by the quality of the available data and the difficulty of comparing outcomes in R/R MCL due to the heterogeneity of the disease, but the results suggest that covalent BTKis should be positioned as second-line therapy, followed by CAR T-cells in BTK-i-relapsed patients. Chemo-free and combination therapies with established chemoimmunotherapy backbones in the relapsed and front-line settings have been recently developed, and front-line options are being improved to move targeted and cellular therapies to earlier lines, including front-line therapy, in elderly and younger fit patients. In the upcoming years, many new targeted agents will play an important role and will be incorporated to the routine practice as their sequence, and outcomes in unselected patients are determined.
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Affiliation(s)
- Juan-Manuel Sancho
- Clinical Hematology Department, ICO-IJC-Hospital Germans Trias I Pujol. Badalona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marc Sorigué
- Clinical Hematology Department, ICO-IJC-Hospital Germans Trias I Pujol. Badalona, Universitat Autònoma de Barcelona, Barcelona, Spain
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2
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Dartigeas C, Slama B, Doyle M, Tapprich C, Albrecht C, Dupuis S, Wapenaar R, Schmidt-Hieber C, Leblond V. FIRE Study: Real-World Effectiveness and Safety of Ibrutinib in Clinical Practice in Patients with CLL and MCL. Clin Hematol Int 2022; 4:65-74. [PMID: 36103041 PMCID: PMC9492818 DOI: 10.1007/s44228-022-00015-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/15/2022] [Indexed: 12/02/2022] Open
Abstract
The FIRE study investigated the real-world effectiveness and safety of ibrutinib in prospectively observed patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) and mantle cell lymphoma (MCL) in France. Patients were mostly relapsed/refractory with high-risk features. First-line CLL/SLL patients had del17p and/or TP53 mutations. In this interim analysis, the median follow-up time for patients with CLL/SLL and MCL was 17.7 and 15.1 months, respectively. In the effectiveness populations for CLL/SLL (n = 200) and MCL (n = 59), the median progression-free survival was not estimable and 12.4 months, respectively; the 12-month overall survival rates were 88.5% and 65.8%, respectively. Treatment-emergent adverse events of interest for patients with CLL/SLL (n = 202) and MCL (n = 59) included: infections and infestations (53.5% and 32.2%), major bleeding (5.0% and 5.1%), and atrial fibrillation (5.9% and 8.5%); 135 (66.8%) and 20 (33.9%) patients were continuing treatment at the time of data cutoff. Future analyses will report on longer-term follow-up (Trial registration: ClinicalTrials.gov, NCT03425591. Registered 1 February 2018—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03425591).
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3
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Arustamyan M, Kibrik P, Hatipoglu D, Bungo B, Mentias A, Hill BT, Moudgil R. The Safety of Bruton's Tyrosine Kinase Inhibitors in B-cell Malignancies: A Systematic Review. Eur J Haematol 2022; 109:696-710. [PMID: 36030394 DOI: 10.1111/ejh.13854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/17/2022] [Accepted: 08/19/2022] [Indexed: 12/01/2022]
Abstract
B-cell malignancies, most notably lymphomas, make up most of the non-Hodgkin lymphomas in the United States. There is limited randomized data comparing 1st and 2nd generation Bruton Tyrosine Kinase inhibitors. Our aim was to compare the safety profiles of 1st versus 2nd generation Bruton Tyrosine Kinase inhibitors. A systematic search was performed from database inception to January 13, 2020. Studies with Bruton Tyrosine Kinase inhibitor monotherapy for the treatment of B-cell malignancies in the adult population (> 18 years old) were utilized and the adverse events were extracted. Fifty-five studies that met the inclusion criteria were included in the systematic review with forty-one studies with 1st generation and fourteen studies with 2nd generation. The review included both clinical trials and retrospective studies with average time of follow-up of 2 years for the 1st generation group and 18 months for the 2nd generation group. We found that the incidence of cardiovascular adverse events was significantly higher in the 1st generation group (20.8%) as compared to the 2nd generation group (6.3%). However, there was a higher incidence of hematologic/oncologic and gastrointestinal side effects in the 2nd generation group compared to the 1st (62.3% compared to 39.2% and 36.9% compare to 28.9%). The number of Grade 5 cardiovascular events (death) were same in the 1st generation group compared to the 2nd generation. Further research is needed to develop highly selective Bruton Tyrosine Kinase inhibitors to avoid unwanted adverse events by minimizing off-targets. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Michael Arustamyan
- Section of Clinical Cardiology, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Section of Leukemia/Lymphoma, Department of Hematology and Medical Oncology
| | - Pavel Kibrik
- Section of Clinical Cardiology, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Section of Leukemia/Lymphoma, Department of Hematology and Medical Oncology
| | - Dilara Hatipoglu
- Section of Clinical Cardiology, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Section of Leukemia/Lymphoma, Department of Hematology and Medical Oncology
| | - Brandon Bungo
- Section of Clinical Cardiology, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Section of Leukemia/Lymphoma, Department of Hematology and Medical Oncology.,Taussig Cancer Institute and Case Comprehensive Cancer Center, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH
| | - Amgad Mentias
- Section of Clinical Cardiology, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Section of Leukemia/Lymphoma, Department of Hematology and Medical Oncology
| | - Brian T Hill
- Taussig Cancer Institute and Case Comprehensive Cancer Center, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH
| | - Rohit Moudgil
- Section of Clinical Cardiology, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Section of Leukemia/Lymphoma, Department of Hematology and Medical Oncology
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4
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Sancho JM, Marín-Niebla A, Fernández S, Capote FJ, Cañigral C, Grande C, Donato E, Zeberio I, Puerta JM, Rivas A, Pérez-Ceballos E, Vale A, Martín García-Sancho A, Salar A, González-Barca E, Teruel A, Pastoriza C, Conde-Royo D, Sánchez-García J, Barrenetxea C, Arranz R, Hernández-Rivas JÁ, Ramírez MJ, Jiménez A, Rubio-Azpeitia E. IBRORS-MCL study: a Spanish retrospective and observational study of relapsed/refractory mantle-cell lymphoma treated with ibrutinib in routine clinical practice. Int J Hematol 2022; 116:381-392. [PMID: 35551632 PMCID: PMC9392694 DOI: 10.1007/s12185-022-03367-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/19/2022] [Accepted: 04/19/2022] [Indexed: 11/30/2022]
Abstract
This retrospective study evaluated 66 patients diagnosed with relapsed and/or refractory mantle cell lymphoma (R/R MCL) treated with ibrutinib in Spain in routine clinical practice. At diagnosis, patients had a median age of 64.5 years, 63.6% presented with intermediate/high sMIPI (simplified prognostic index for advanced-stage mantle cell lymphoma), 24.5% had the blastoid variant, and 55.6% had a Ki67 > 30%. Patients had received a median of 2 prior lines of therapy (range 1-2; min-max 1-7). Overall response rate was 63.5%, with 38.1% of patients achieving complete response (CR). With a median duration of ibrutinib exposure of 10.7 months (range 5.2-19.6; min-max 0.3-36), the median progression-free survival (PFS) and overall survival (OS) were 20 months [95% confidence interval (CI) 8.8-31.1] and 32 months (95% CI 22.6-41.3), respectively, and were not reached in patients achieving CR. No grade ≥ 3 cardiovascular toxicity or bleeding was reported. This study supports that treatment with ibrutinib leads to high response rates and favorable survival outcomes in patients with R/R MCL.
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Affiliation(s)
- Juan-Manuel Sancho
- Clinical Hematology Department, Catalan Institute of Oncology (ICO), ICO Hospital Germans Trias i Pujol, Carretera de Canyet, s/n, 08916, Badalona, Barcelona, Spain.
| | - Ana Marín-Niebla
- Hospital Universitario Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | | | | | - Carolina Cañigral
- Hospital de Castellón, Av. de Benicàssim, 128, 12004, Castellón de la Plana, Castellón, Spain
| | - Carlos Grande
- Hospital Doce de Octubre, Av. de Córdoba, s/n, 28041, Madrid, Spain
| | - Eva Donato
- Hospital Universitario Dr. Peset, Av. de Gaspar Aguilar, 90, 46017, Valencia, Spain
| | - Izaskun Zeberio
- Hospital Donostia, Begiristain Doktorea Pasealekua, s/n, 20014, Donostia, Gipuzkoa, Spain
| | - Jose-Manuel Puerta
- Hospital Virgen de Las Nieves, Av. de las Fuerzas Armadas, 2, 18014, Granada, Spain
| | - Alfredo Rivas
- Hospital Clìnic i Provincial, C. de Villarroel, 170, 08036, Barcelona, Spain
| | | | - Ana Vale
- Complejo Hospitalario Universiatrio A Coruña, As Xubias, 84, 15006 A, Coruña, Spain
| | | | - Antonio Salar
- Hospital del Mar, Passeig Marítim de la Barceloneta, 25, 29, 08003, Barcelona, Spain
| | - Eva González-Barca
- Hospital Duran i Reynals, Av. de la Granvia de l'Hospitalet, 199,, 08908, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Anabel Teruel
- Hospital Clínico Universitario de Valencia, Av. de Blasco Ibáñez, 17, 46010, Valencia, Spain
| | - Carmen Pastoriza
- Hospital de Orense, Ramón Puga Noguerol, 54, 32005, Orense, Spain
| | - Diego Conde-Royo
- Hospital Príncipe de Asturias, Carr. de Alcalá, s/n, 28805, Meco, Madrid, Spain
| | | | | | - Reyes Arranz
- Hospital la Princesa, Diego de León, 62, 28006, Madrid, Spain
| | | | - María-José Ramírez
- Hospital Universitario de Jerez, Ctra. Trebujena, s/n, 11407, Jerez de la Frontera, Cádiz, Spain
| | - Aroa Jiménez
- Medical Department Janssen-Cilag, S.A., Madrid, Spain
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Zhang Y, Liu P, Cai J, Jing H, Zou L, Huang H, Wu Y, Li W, Zhong L, Jin X, Ye X, Feng R, Zhang H, Zhang L, Lin L, Sun X, Tian Y, Xia Z, Li Z, Huang H, Xia Y, Cai Q. Ibrutinib as monotherapy versus combination therapy in Chinese patients with relapsed/refractory mantle cell lymphoma: A multicenter study. Cancer Med 2022; 11:4134-4145. [PMID: 35438258 DOI: 10.1002/cam4.4765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 02/18/2022] [Accepted: 04/09/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Ibrutinib has revolutionized the treatment of mantle cell lymphoma (MCL). Both ibrutinib monotherapy and ibrutinib-based combination therapy are important salvage options for patients with relapsed/refractory (R/R) MCL. The real-world efficacy and safety profile of the two strategies in Chinese patients with R/R MCL remain unclarified. METHODS In the present study, data of 121 R/R MCL patients who received either ibrutinib monotherapy (N = 68) or ibrutinib combination therapy (N = 53) in 13 medical centers in China were retrospectively reviewed. RESULTS With a median follow-up of 20.5 months, the overall response rate was 60.3% versus 84.9% (p = 0.003), complete remission rate was 16.2% versus 43.4% (p < 0.001), and median progression-free survival (PFS) was 18.5 months (95% confidence interval [CI], 12.1-21.8) vs. 30.8 months (95% CI, 23.5-NR) (hazard ratio, 0.53 [95% CI, 0.30-0.93]; p = 0.025), with ibrutinib monotherapy and ibrutinib-based combination therapy, respectively. Subgroup analysis showed that patients with male gender, no refractory disease, Ki67 <30%, previous line of therapy = 1, non-blastoid subtype, and the number of extranodal sites involved <2 might benefits more from the combination therapy. Treatment-emergent adverse events were similar, except for a higher incidence of all grade neutropenia in the ibrutinib combination group (12.7% vs. 32.0%, p = 0.017). CONCLUSIONS Ibrutinib combination therapy demonstrated potentially superior efficacy and comparable tolerability to ibrutinib monotherapy. Ibrutinib-based combination therapy could be one of the prominent treatment options for R/R MCL patients.
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Affiliation(s)
- Yuchen Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Panpan Liu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Jun Cai
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Hongmei Jing
- Department of Hematology, Peking University Third Hospital, Beijing, P.R. China
| | - Liqun Zou
- Department of Oncology, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Huiqiang Huang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Yuanbin Wu
- Department of Hematology, Guangdong Province Traditional Chinese Medical Hospital, Guangzhou, P.R. China
| | - Wenyu Li
- Division of Lymphoma, Department of Clinical Oncology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China
| | - Liye Zhong
- Department of Hematology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China
| | - Xueli Jin
- Department of Hematology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, P.R. China
| | - Xu Ye
- Department of Hematology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, P.R. China
| | - Ru Feng
- Department of Hematology, Nanfang Hospital of Nanfang Medical University, Guangzhou, P.R. China
| | - Huilai Zhang
- Department of Lymphoma, Tianjin Medical University Cancer Hospital and Institute, Tianjin, P.R. China
| | - Liling Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Lie Lin
- Department of Hematology, Hainan General Hospital, Haikou, P.R. China
| | - Xiuhua Sun
- Myeloma and Lymphoma Research Center, Second Affiliated Hospital of Dalian Medical University, Dalian, P.R. China
| | - Yuyang Tian
- Department of Hematology, Hainan Cancer Hospital, Haikou, P.R. China
| | - Zhongjun Xia
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.,Department of Hematologic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Zhiming Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - He Huang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Yi Xia
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Qingqing Cai
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
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6
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Alnassfan T, Cox‐Pridmore MJ, Taktak A, Till KJ. Mantle cell lymphoma treatment options for elderly/unfit patients: A systematic review. EJHAEM 2022; 3:276-290. [PMID: 35846186 PMCID: PMC9175944 DOI: 10.1002/jha2.311] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 09/21/2021] [Indexed: 12/23/2022]
Affiliation(s)
- Tahera Alnassfan
- Department of Molecular and Clinical Cancer Medicine University of Liverpool Liverpool UK
- Authors Tahera Alnassfan and Megan J. Cox‐Pridmore contributed equally to the review
| | - Megan J. Cox‐Pridmore
- Department of Molecular and Clinical Cancer Medicine University of Liverpool Liverpool UK
- Authors Tahera Alnassfan and Megan J. Cox‐Pridmore contributed equally to the review
| | - Azzam Taktak
- Medical Physics and Clinical Engineering Royal Liverpool University Hospital Liverpool UK
| | - Kathleen J Till
- Department of Molecular and Clinical Cancer Medicine University of Liverpool Liverpool UK
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7
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Cencini E, Mecacci B, Morelli F, Ghio F, Romano I, Birtolo S, Simonetti F, Zoi V, Moretti S, Sant’Antonio E, Cuccaro A, Santini S, Kovalchuk S, Galimberti S, Bocchia M, Fabbri A. Ibrutinib in patients with relapsed/refractory mantle cell lymphoma: a real-life, retrospective, multicenter trial on behalf of the "RTL" (regional Tuscan lymphoma network). AMERICAN JOURNAL OF BLOOD RESEARCH 2021; 11:373-383. [PMID: 34540345 PMCID: PMC8446834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/14/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Relapsed or refractory (R/R) mantle-cell lymphoma (MCL) patients have a poor prognosis and their management is challenging, in absence of a golden standard as salvage treatment. Bruton's tyrosine kinase inhibitor ibrutinib represents an effective treatment for R/R MCL patients. We investigated ibrutinib efficacy and safety in daily clinical practice, together with factors that could predict disease outcome. PATIENTS AND METHODS We retrospectively analyzed 69 consecutive R/R MCL patients managed in 10 Tuscan onco-hematological centers. The treatment regimen consisted of oral, continuous, single-agent ibrutinib, maximum dosage of 560 mg once per day, until disease progression. RESULTS Overall response rate was 62.3%, with a CR rate of 39.1%. After a median follow-up of 15.6 months, 40/69 patients (58%) were alive, the main cause of death was progressive disease (PD, 22/69 cases, 31.9%). Median progression-free survival (PFS) and overall survival (OS) were 17 and 34.8 months. Inferior PFS was associated with >1 prior line of therapy and B symptoms. Ibrutinib refractoriness was associated with inferior OS, median OS after ibrutinib failure was only 5 months. DISCUSSION AND CONCLUSION In this real-life setting ibrutinib treatment prolonged survival in R/R MCL patients, without unexpected adverse events. Patients receiving ibrutinib as 2nd line regimen had the most favorable outcome.
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Affiliation(s)
- Emanuele Cencini
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese and University of SienaSiena, Italy
| | - Bianca Mecacci
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese and University of SienaSiena, Italy
| | - Francesca Morelli
- Lymphoma Unit, Hematology Department, Careggi Hospital and University of FlorenceFlorence, Italy
| | - Francesco Ghio
- Unit of Hematology, Azienda Ospedaliera Universitaria Pisana and University of PisaPisa, Italy
| | - Ilaria Romano
- Lymphoma Unit, Hematology Department, Careggi Hospital and University of FlorenceFlorence, Italy
| | | | - Federico Simonetti
- UOC Ematologia Dipartimentale ATNO, Ospedale VersiliaLido di Camaiore, Italy
| | | | | | - Emanuela Sant’Antonio
- UOC Ematologia Aziendale, Azienda USL Toscana Nordovest, Ospedale S. LucaLucca, Italy
| | - Annarosa Cuccaro
- UOC Ematologia Aziendale, Azienda USL Toscana Nordovest, Spedali RiunitiLivorno, Italy
| | | | - Sofia Kovalchuk
- Lymphoma Unit, Hematology Department, Careggi Hospital and University of FlorenceFlorence, Italy
| | - Sara Galimberti
- Unit of Hematology, Azienda Ospedaliera Universitaria Pisana and University of PisaPisa, Italy
| | - Monica Bocchia
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese and University of SienaSiena, Italy
| | - Alberto Fabbri
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese and University of SienaSiena, Italy
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8
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Risk of bleeding complications and atrial fibrillation associated with ibrutinib treatment: A systematic review and meta-analysis. Crit Rev Oncol Hematol 2021; 159:103238. [DOI: 10.1016/j.critrevonc.2021.103238] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 08/28/2020] [Accepted: 01/16/2021] [Indexed: 12/21/2022] Open
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9
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Yi JH, Kim SJ, Yoon DH, Suh C, Chang MH, Yang DH, Jo JC, Hyun SY, Eom HS, Lee JO, Kwon JH, Han SH, Lee SS, Kwak JY, Kim SH, Kim DS, Lee JH, Oh SY, Ryoo HM, Kim HJ, Kim WS. Real-world outcomes of ibrutinib therapy in Korean patients with relapsed or refractory mantle cell lymphoma: a multicenter, retrospective analysis. Cancer Commun (Lond) 2021; 41:275-278. [PMID: 33626235 PMCID: PMC7968880 DOI: 10.1002/cac2.12150] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/30/2021] [Accepted: 02/17/2021] [Indexed: 11/09/2022] Open
Affiliation(s)
- Jun Ho Yi
- Division of Hematology-Oncology, Department of Medicine, Chung-Ang University, Dongjak-gu, Seoul, 06973, Korea
| | - Seok Jin Kim
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, 06351, Korea
| | - Dok Hyun Yoon
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, 05505, Korea
| | - Cheolwon Suh
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, 05505, Korea
| | - Myung Hee Chang
- National Health Insurance Corporation Ilsan Hospital, Ilsandong-gu, Goyang, 10444, Korea
| | - Deok Hwan Yang
- Department of Hemato-Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Gwangju, 58128, Korea
| | - Jae-Cheol Jo
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Dong-gu, Ulsan, 44033, Korea
| | - Shin Young Hyun
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Gangwon-Do, Wonju, 26426, Korea
| | - Hyeon-Seok Eom
- Department of Internal Medicine, National Cancer Center, Goyang-si Gyeonggi-do, Goyang, 10408, Korea
| | - Jeong-Ok Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Bundang-gu, Seongnam, 13620, Korea
| | - Ji Hyun Kwon
- Department of Internal Medicine, ChungBuk National University Hospital, Chungbuk, Cheongju, 28644, Korea
| | - Sang Hoon Han
- Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, 63241, Korea
| | - Seung-Shin Lee
- Department of Hematology-Oncology, Wonkwang University Hospital, Iksan-daero, Iksan, 54538, Korea
| | - Jae-Yong Kwak
- Department of Internal Medicine, Jeonbuk National University Medical School, Jeollabuk-do, Jeonju, 54907, Korea
| | - Se Hyung Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Soonchunhyang University, College of Medicine, Bucheon Hospital, Wonmi-gu, Bucheon, 14584, Korea
| | - Dae Sik Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Korea University Guro Hospital, Guro-gu, Seoul, 08308, Korea
| | - Ji Hyun Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Dong-A University College of Medicine, Seo-gu, Busan, 49201, Korea
| | - Sung Yong Oh
- Division of Hematology-Oncology, Department of Internal Medicine, Dong-A University College of Medicine, Seo-gu, Busan, 49201, Korea
| | - Hun Mo Ryoo
- Department of Internal Medicine, Division of Hematology-Oncology, Catholic University of Daegu, Daegu, 42472, Korea
| | - Hyo Jung Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Dongan-gu, Anyang, 14068, Korea
| | - Won Seog Kim
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, 06351, Korea
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Sharman J, Kabadi SM, Clark J, Andorsky D. Treatment patterns and outcomes among mantle cell lymphoma patients treated with ibrutinib in the United States: a retrospective electronic medical record database and chart review study. Br J Haematol 2020; 192:737-746. [PMID: 33095453 DOI: 10.1111/bjh.16922] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 06/04/2020] [Indexed: 11/27/2022]
Abstract
The experience of patients with mantle cell lymphoma (MCL) in community oncology practices, including reasons for treatment discontinuation, is sparse. This retrospective study sought to elucidate treatment patterns and outcomes of patients with MCL treated with ibrutinib in the community setting. Patients were identified from the US Oncology Network electronic medical records database, iKnowMedTM , between 1 November 2013 and 31 October 2016. Descriptive analysis was performed to describe the demographic and clinical characteristics of the population. Kaplan-Meier estimates were performed to determine clinical outcomes. A Cox proportional hazards model was used to identify predictors of survival. Of the 1914 patients identified with MCL, 159 were treated with ibrutinib. The median age was 71 years and the majority were male (76%) and Caucasian (89%). The overall discontinuation rate was 83·6%; the most common reasons were progression (35%) and toxicities (25·6%). The median overall survival and progression-free survival was 25·82 months (95% confidence interval [CI] 19·94, NR) and 19·55 months (95% CI 16·52, 24·28) respectively. In multivariate modelling, patient age was predictive of survival (hazard ratio 1·041, P = 0·0186). Ibrutinib was temporarily reduced in 16·4% (n = 26) and held in 30·2% (n = 48), primarily due to toxicity 66·7% (n = 32). Survival data showed similarities between community oncology practices and clinical trials.
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Affiliation(s)
- Jeff Sharman
- The US Oncology Network/McKesson Specialty Health, Woodlands, TX, USA.,Willamette Valley Cancer Institute and Research Center, Eugene, OR, USA
| | | | - Jamyia Clark
- The US Oncology Network/McKesson Specialty Health, Woodlands, TX, USA
| | - David Andorsky
- The US Oncology Network/McKesson Specialty Health, Woodlands, TX, USA.,Rocky Mountain Cancer Centers, Boulder, CO, USA
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Jeon YW, Yoon S, Min GJ, Park SS, Park S, Yoon JH, Lee SE, Cho BS, Eom KS, Kim YJ, Kim HJ, Lee S, Min CK, Lee JW, Cho SG. Clinical outcomes for ibrutinib in relapsed or refractory mantle cell lymphoma in real-world experience. Cancer Med 2019; 8:6860-6870. [PMID: 31560165 PMCID: PMC6853811 DOI: 10.1002/cam4.2565] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 07/24/2019] [Accepted: 09/04/2019] [Indexed: 12/22/2022] Open
Abstract
Ibrutinib is highly effective in patients with relapsed or refractory mantle cell lymphoma (MCL) in major clinical trials. Although there has been a dramatic improvement in survival outcomes in the salvage setting, nonresponders to ibrutinib have a bleak prognosis. Therefore, this retrospective study was conducted to identify the most appropriate therapeutic strategy and prognosis‐related factors to predict the response of patients with relapsed or refractory MCL to ibrutinib monotherapy. Thirty‐three consecutive refractory or relapsed MCL patients treated with ibrutinib were analyzed in this study. The median overall survival (OS) and progression‐free survival (PFS) after initiation of ibrutinib were 35.1 months and 27.4 months, respectively. Risk factor analysis showed that high risk according to the Mantle Cell Lymphoma International Prognostic Index (MIPI) and nonresponse to ibrutinib at the first three cycles were significantly associated with inferior OS. Poor PFS was associated with high‐risk biologic MIPI, prior bendamustine exposure, and nonresponse to ibrutinib during the first three cycles. After ibrutinib failure, primary nonresponders had poorer OS and PFS than inconsistent responders. The overall response rate for the first salvage therapy was only 33%, with a median TTP of 3.2 months. There was no effective therapeutic strategy except for allogeneic hematopoietic stem cell transplantation (allo‐HSCT). Although ibrutinib responders exhibited favorable survival outcomes, nonresponders had a dismal prognosis. To overcome these limitations, it may be necessary to modify therapeutic strategies, such as selecting inconsistent responders for earlier allo‐HSCT.
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Affiliation(s)
- Young-Woo Jeon
- Division of Lymphoma-Myeloma, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Institute for Translational Research and Molecular Imaging, Catholic Institutes of Medical Science, Seoul, Korea.,Laboratory of Immune Regulation, Convergent Research Consortium for Immunologic Disease, Seoul St. Mary's Hospital, Seoul, Korea
| | - Seugyun Yoon
- Division of Lymphoma-Myeloma, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Gi June Min
- Division of Lymphoma-Myeloma, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung-Soo Park
- Division of Lymphoma-Myeloma, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Silvia Park
- Division of Lymphoma-Myeloma, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jae-Ho Yoon
- Division of Lymphoma-Myeloma, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung-Eun Lee
- Division of Lymphoma-Myeloma, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Byung-Sik Cho
- Division of Lymphoma-Myeloma, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ki-Seong Eom
- Division of Lymphoma-Myeloma, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoo-Jin Kim
- Division of Lymphoma-Myeloma, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hee-Je Kim
- Division of Lymphoma-Myeloma, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seok Lee
- Division of Lymphoma-Myeloma, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chang-Ki Min
- Division of Lymphoma-Myeloma, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong Wook Lee
- Division of Lymphoma-Myeloma, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seok-Goo Cho
- Division of Lymphoma-Myeloma, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Institute for Translational Research and Molecular Imaging, Catholic Institutes of Medical Science, Seoul, Korea.,Laboratory of Immune Regulation, Convergent Research Consortium for Immunologic Disease, Seoul St. Mary's Hospital, Seoul, Korea
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12
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Acalabrutinib for mantle cell lymphoma. Blood 2019; 133:2570-2574. [DOI: 10.1182/blood.2019852368] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 03/11/2019] [Indexed: 01/03/2023] Open
Abstract
Abstract
Mantle cell lymphoma (MCL) is a unique type of non-Hodgkin lymphoma characterized by the overexpression of cyclin D1. MCL patients typically live for years but experience multiple relapses. Acalabrutinib is a novel second-generation oral Bruton tyrosine kinase inhibitor approved by the US Food and Drug Administration for relapsed MCL based on a clinical trial demonstrating an overall response rate of 81%. It provides a valuable new treatment option for MCL patients and is now being tested upfront.
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