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Jin J, Okamoto R, Yoon SS, Shih LY, Zhu J, Liu T, Hong X, Pei L, Rooney B, van de Velde H, Huang H. Bortezomib-based therapy for transplant-ineligible East Asian patients with newly diagnosed mantle-cell lymphoma. Onco Targets Ther 2018; 11:3869-3882. [PMID: 30013367 PMCID: PMC6039072 DOI: 10.2147/ott.s150339] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Introduction This subgroup analysis of the LYM-3002 Phase III study (NCT00722137) investigated whether substituting bortezomib for vincristine in frontline R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) therapy could improve outcomes in East Asian patients with newly diagnosed mantle-cell lymphoma (MCL). Materials and methods A total of 121 East Asian patients from China, Taiwan, Japan, and the Republic of Korea with stage II–IV MCL who were ineligible or not considered for stem-cell transplantation were enrolled to six to eight 21-day cycles of R-CHOP or VR-CAP (R-CHOP with bortezomib replacing vincristine). Results The primary end point was progression-free survival. After a median follow-up of 42.4 months, median progression-free survival in East Asian patients was 13.9 (R-CHOP) versus 28.6 (VR-CAP) months (HR 0.7, P=0.157; 43% improvement with VR-CAP). Secondary end points (R-CHOP vs VR-CAP), including complete response rate (47% vs 63%), duration of complete response (median 16.6 vs 46.7 months), and treatment-free interval (median 21 vs 46.5 months), were improved with VR-CAP. VR-CAP was associated with increased but manageable toxicity. The most frequent adverse events were hematologic toxicities. Conclusion VR-CAP was effective in East Asian patients with newly diagnosed MCL, and could be considered for patients in whom stem-cell transplantation is not an option.
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Affiliation(s)
- Jie Jin
- Department of Hematology, The First Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, Zhejiang, China.,Key Laboratory of Hematologic Malignancies, Diagnosis and Treatment, Hangzhou, Zhejiang, China
| | - Rumiko Okamoto
- Department of Chemotherapy, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Sung-Soo Yoon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Lee-Yung Shih
- Division of Hematology-Oncology, Chang Gung Memorial Hospital-Linkou, Chang Gung University, Taoyuan, Taiwan
| | - Jun Zhu
- Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Ting Liu
- Division of Hematology, Department of Internal Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiaonan Hong
- Lymphoma and GI Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Lixia Pei
- Janssen Research & Development, LLC, Raritan, NJ, USA
| | - Brendan Rooney
- Janssen Research & Development, High Wycombe, Buckinghamshire, UK
| | - Helgi van de Velde
- Oncology Clinical Research, Millennium Pharmaceuticals, Inc., Boston, MA, USA
| | - Huiqiang Huang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China,
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Hoster E, Klapper W, Hermine O, Kluin-Nelemans HC, Walewski J, van Hoof A, Trneny M, Geisler CH, Di Raimondo F, Szymczyk M, Stilgenbauer S, Thieblemont C, Hallek M, Forstpointner R, Pott C, Ribrag V, Doorduijn J, Hiddemann W, Dreyling MH, Unterhalt M. Confirmation of the Mantle-Cell Lymphoma International Prognostic Index in Randomized Trials of the European Mantle-Cell Lymphoma Network. J Clin Oncol 2014; 32:1338-46. [DOI: 10.1200/jco.2013.52.2466] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
PurposeMantle-cell lymphoma (MCL) is a distinct B-cell lymphoma associated with poor outcome. In 2008, the MCL International Prognostic Index (MIPI) was developed as the first prognostic stratification tool specifically directed to patients with MCL. External validation was planned to be performed on the cohort of the two recently completed randomized trials of the European MCL Network.Patients and MethodsData of 958 patients with MCL (median age, 65 years; range, 32 to 87 years) treated upfront in the trials MCL Younger or MCL Elderly were pooled to assess the prognostic value of MIPI with respect to overall survival (OS) and time to treatment failure (TTF).ResultsFive-year OS rates in MIPI low, intermediate, and high-risk groups were 83%, 63%, and 34%, respectively. The hazard ratios for OS of intermediate versus low and high versus intermediate risk patients were 2.1 (95% CI, 1.5 to 2.9) and 2.6 (2.0 to 3.3), respectively. MIPI was similarly prognostic for TTF. All four clinical baseline characteristics constituting the MIPI, age, performance status, lactate dehydrogenase level, and WBC count, were confirmed as independent prognostic factors for OS and TTF. The validity of MIPI was independent of trial cohort and treatment strategy.ConclusionMIPI was prospectively validated in a large MCL patient cohort homogenously treated according to recognized standards. As reflected in current guidelines, MIPI represents a generally applicable prognostic tool to be used in research as well as in clinical routine, and it can help to develop risk-adapted treatment strategies to further improve clinical outcome in MCL.
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Affiliation(s)
- Eva Hoster
- Eva Hoster, Roswitha Forstpointner, Wolfgang Hiddemann, Martin H. Dreyling, and Michael Unterhalt, University Hospital Munich; Eva Hoster, University of Munich, Munich; Wolfram Klapper, University of Kiel; Christiane Pott, University Hospital Schleswig-Holstein, Kiel; Michael Hallek, Universität Köln, Köln; Stephan Stilgenbauer, University of Ulm, Ulm, Germany; Olivier Hermine, University Paris Descartes and Université Sorbonne Paris Cité; Catherine Thieblemont, Hôpital Saint Louis, Paris; Vincent Ribrag
| | - Wolfram Klapper
- Eva Hoster, Roswitha Forstpointner, Wolfgang Hiddemann, Martin H. Dreyling, and Michael Unterhalt, University Hospital Munich; Eva Hoster, University of Munich, Munich; Wolfram Klapper, University of Kiel; Christiane Pott, University Hospital Schleswig-Holstein, Kiel; Michael Hallek, Universität Köln, Köln; Stephan Stilgenbauer, University of Ulm, Ulm, Germany; Olivier Hermine, University Paris Descartes and Université Sorbonne Paris Cité; Catherine Thieblemont, Hôpital Saint Louis, Paris; Vincent Ribrag
| | - Olivier Hermine
- Eva Hoster, Roswitha Forstpointner, Wolfgang Hiddemann, Martin H. Dreyling, and Michael Unterhalt, University Hospital Munich; Eva Hoster, University of Munich, Munich; Wolfram Klapper, University of Kiel; Christiane Pott, University Hospital Schleswig-Holstein, Kiel; Michael Hallek, Universität Köln, Köln; Stephan Stilgenbauer, University of Ulm, Ulm, Germany; Olivier Hermine, University Paris Descartes and Université Sorbonne Paris Cité; Catherine Thieblemont, Hôpital Saint Louis, Paris; Vincent Ribrag
| | - Hanneke C. Kluin-Nelemans
- Eva Hoster, Roswitha Forstpointner, Wolfgang Hiddemann, Martin H. Dreyling, and Michael Unterhalt, University Hospital Munich; Eva Hoster, University of Munich, Munich; Wolfram Klapper, University of Kiel; Christiane Pott, University Hospital Schleswig-Holstein, Kiel; Michael Hallek, Universität Köln, Köln; Stephan Stilgenbauer, University of Ulm, Ulm, Germany; Olivier Hermine, University Paris Descartes and Université Sorbonne Paris Cité; Catherine Thieblemont, Hôpital Saint Louis, Paris; Vincent Ribrag
| | - Jan Walewski
- Eva Hoster, Roswitha Forstpointner, Wolfgang Hiddemann, Martin H. Dreyling, and Michael Unterhalt, University Hospital Munich; Eva Hoster, University of Munich, Munich; Wolfram Klapper, University of Kiel; Christiane Pott, University Hospital Schleswig-Holstein, Kiel; Michael Hallek, Universität Köln, Köln; Stephan Stilgenbauer, University of Ulm, Ulm, Germany; Olivier Hermine, University Paris Descartes and Université Sorbonne Paris Cité; Catherine Thieblemont, Hôpital Saint Louis, Paris; Vincent Ribrag
| | - Achiel van Hoof
- Eva Hoster, Roswitha Forstpointner, Wolfgang Hiddemann, Martin H. Dreyling, and Michael Unterhalt, University Hospital Munich; Eva Hoster, University of Munich, Munich; Wolfram Klapper, University of Kiel; Christiane Pott, University Hospital Schleswig-Holstein, Kiel; Michael Hallek, Universität Köln, Köln; Stephan Stilgenbauer, University of Ulm, Ulm, Germany; Olivier Hermine, University Paris Descartes and Université Sorbonne Paris Cité; Catherine Thieblemont, Hôpital Saint Louis, Paris; Vincent Ribrag
| | - Marek Trneny
- Eva Hoster, Roswitha Forstpointner, Wolfgang Hiddemann, Martin H. Dreyling, and Michael Unterhalt, University Hospital Munich; Eva Hoster, University of Munich, Munich; Wolfram Klapper, University of Kiel; Christiane Pott, University Hospital Schleswig-Holstein, Kiel; Michael Hallek, Universität Köln, Köln; Stephan Stilgenbauer, University of Ulm, Ulm, Germany; Olivier Hermine, University Paris Descartes and Université Sorbonne Paris Cité; Catherine Thieblemont, Hôpital Saint Louis, Paris; Vincent Ribrag
| | - Christian H. Geisler
- Eva Hoster, Roswitha Forstpointner, Wolfgang Hiddemann, Martin H. Dreyling, and Michael Unterhalt, University Hospital Munich; Eva Hoster, University of Munich, Munich; Wolfram Klapper, University of Kiel; Christiane Pott, University Hospital Schleswig-Holstein, Kiel; Michael Hallek, Universität Köln, Köln; Stephan Stilgenbauer, University of Ulm, Ulm, Germany; Olivier Hermine, University Paris Descartes and Université Sorbonne Paris Cité; Catherine Thieblemont, Hôpital Saint Louis, Paris; Vincent Ribrag
| | - Francesco Di Raimondo
- Eva Hoster, Roswitha Forstpointner, Wolfgang Hiddemann, Martin H. Dreyling, and Michael Unterhalt, University Hospital Munich; Eva Hoster, University of Munich, Munich; Wolfram Klapper, University of Kiel; Christiane Pott, University Hospital Schleswig-Holstein, Kiel; Michael Hallek, Universität Köln, Köln; Stephan Stilgenbauer, University of Ulm, Ulm, Germany; Olivier Hermine, University Paris Descartes and Université Sorbonne Paris Cité; Catherine Thieblemont, Hôpital Saint Louis, Paris; Vincent Ribrag
| | - Michal Szymczyk
- Eva Hoster, Roswitha Forstpointner, Wolfgang Hiddemann, Martin H. Dreyling, and Michael Unterhalt, University Hospital Munich; Eva Hoster, University of Munich, Munich; Wolfram Klapper, University of Kiel; Christiane Pott, University Hospital Schleswig-Holstein, Kiel; Michael Hallek, Universität Köln, Köln; Stephan Stilgenbauer, University of Ulm, Ulm, Germany; Olivier Hermine, University Paris Descartes and Université Sorbonne Paris Cité; Catherine Thieblemont, Hôpital Saint Louis, Paris; Vincent Ribrag
| | - Stephan Stilgenbauer
- Eva Hoster, Roswitha Forstpointner, Wolfgang Hiddemann, Martin H. Dreyling, and Michael Unterhalt, University Hospital Munich; Eva Hoster, University of Munich, Munich; Wolfram Klapper, University of Kiel; Christiane Pott, University Hospital Schleswig-Holstein, Kiel; Michael Hallek, Universität Köln, Köln; Stephan Stilgenbauer, University of Ulm, Ulm, Germany; Olivier Hermine, University Paris Descartes and Université Sorbonne Paris Cité; Catherine Thieblemont, Hôpital Saint Louis, Paris; Vincent Ribrag
| | - Catherine Thieblemont
- Eva Hoster, Roswitha Forstpointner, Wolfgang Hiddemann, Martin H. Dreyling, and Michael Unterhalt, University Hospital Munich; Eva Hoster, University of Munich, Munich; Wolfram Klapper, University of Kiel; Christiane Pott, University Hospital Schleswig-Holstein, Kiel; Michael Hallek, Universität Köln, Köln; Stephan Stilgenbauer, University of Ulm, Ulm, Germany; Olivier Hermine, University Paris Descartes and Université Sorbonne Paris Cité; Catherine Thieblemont, Hôpital Saint Louis, Paris; Vincent Ribrag
| | - Michael Hallek
- Eva Hoster, Roswitha Forstpointner, Wolfgang Hiddemann, Martin H. Dreyling, and Michael Unterhalt, University Hospital Munich; Eva Hoster, University of Munich, Munich; Wolfram Klapper, University of Kiel; Christiane Pott, University Hospital Schleswig-Holstein, Kiel; Michael Hallek, Universität Köln, Köln; Stephan Stilgenbauer, University of Ulm, Ulm, Germany; Olivier Hermine, University Paris Descartes and Université Sorbonne Paris Cité; Catherine Thieblemont, Hôpital Saint Louis, Paris; Vincent Ribrag
| | - Roswitha Forstpointner
- Eva Hoster, Roswitha Forstpointner, Wolfgang Hiddemann, Martin H. Dreyling, and Michael Unterhalt, University Hospital Munich; Eva Hoster, University of Munich, Munich; Wolfram Klapper, University of Kiel; Christiane Pott, University Hospital Schleswig-Holstein, Kiel; Michael Hallek, Universität Köln, Köln; Stephan Stilgenbauer, University of Ulm, Ulm, Germany; Olivier Hermine, University Paris Descartes and Université Sorbonne Paris Cité; Catherine Thieblemont, Hôpital Saint Louis, Paris; Vincent Ribrag
| | - Christiane Pott
- Eva Hoster, Roswitha Forstpointner, Wolfgang Hiddemann, Martin H. Dreyling, and Michael Unterhalt, University Hospital Munich; Eva Hoster, University of Munich, Munich; Wolfram Klapper, University of Kiel; Christiane Pott, University Hospital Schleswig-Holstein, Kiel; Michael Hallek, Universität Köln, Köln; Stephan Stilgenbauer, University of Ulm, Ulm, Germany; Olivier Hermine, University Paris Descartes and Université Sorbonne Paris Cité; Catherine Thieblemont, Hôpital Saint Louis, Paris; Vincent Ribrag
| | - Vincent Ribrag
- Eva Hoster, Roswitha Forstpointner, Wolfgang Hiddemann, Martin H. Dreyling, and Michael Unterhalt, University Hospital Munich; Eva Hoster, University of Munich, Munich; Wolfram Klapper, University of Kiel; Christiane Pott, University Hospital Schleswig-Holstein, Kiel; Michael Hallek, Universität Köln, Köln; Stephan Stilgenbauer, University of Ulm, Ulm, Germany; Olivier Hermine, University Paris Descartes and Université Sorbonne Paris Cité; Catherine Thieblemont, Hôpital Saint Louis, Paris; Vincent Ribrag
| | - Jeanette Doorduijn
- Eva Hoster, Roswitha Forstpointner, Wolfgang Hiddemann, Martin H. Dreyling, and Michael Unterhalt, University Hospital Munich; Eva Hoster, University of Munich, Munich; Wolfram Klapper, University of Kiel; Christiane Pott, University Hospital Schleswig-Holstein, Kiel; Michael Hallek, Universität Köln, Köln; Stephan Stilgenbauer, University of Ulm, Ulm, Germany; Olivier Hermine, University Paris Descartes and Université Sorbonne Paris Cité; Catherine Thieblemont, Hôpital Saint Louis, Paris; Vincent Ribrag
| | - Wolfgang Hiddemann
- Eva Hoster, Roswitha Forstpointner, Wolfgang Hiddemann, Martin H. Dreyling, and Michael Unterhalt, University Hospital Munich; Eva Hoster, University of Munich, Munich; Wolfram Klapper, University of Kiel; Christiane Pott, University Hospital Schleswig-Holstein, Kiel; Michael Hallek, Universität Köln, Köln; Stephan Stilgenbauer, University of Ulm, Ulm, Germany; Olivier Hermine, University Paris Descartes and Université Sorbonne Paris Cité; Catherine Thieblemont, Hôpital Saint Louis, Paris; Vincent Ribrag
| | - Martin H. Dreyling
- Eva Hoster, Roswitha Forstpointner, Wolfgang Hiddemann, Martin H. Dreyling, and Michael Unterhalt, University Hospital Munich; Eva Hoster, University of Munich, Munich; Wolfram Klapper, University of Kiel; Christiane Pott, University Hospital Schleswig-Holstein, Kiel; Michael Hallek, Universität Köln, Köln; Stephan Stilgenbauer, University of Ulm, Ulm, Germany; Olivier Hermine, University Paris Descartes and Université Sorbonne Paris Cité; Catherine Thieblemont, Hôpital Saint Louis, Paris; Vincent Ribrag
| | - Michael Unterhalt
- Eva Hoster, Roswitha Forstpointner, Wolfgang Hiddemann, Martin H. Dreyling, and Michael Unterhalt, University Hospital Munich; Eva Hoster, University of Munich, Munich; Wolfram Klapper, University of Kiel; Christiane Pott, University Hospital Schleswig-Holstein, Kiel; Michael Hallek, Universität Köln, Köln; Stephan Stilgenbauer, University of Ulm, Ulm, Germany; Olivier Hermine, University Paris Descartes and Université Sorbonne Paris Cité; Catherine Thieblemont, Hôpital Saint Louis, Paris; Vincent Ribrag
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