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Cencini E, Calomino N, Franceschini M, Dragomir A, Fredducci S, Esposito Vangone B, Lucco Navei G, Fabbri A, Bocchia M. Survival Outcomes of Patients with Mantle Cell Lymphoma: A Retrospective, 15-Year, Real-Life Study. Hematol Rep 2024; 16:50-62. [PMID: 38247996 PMCID: PMC10801596 DOI: 10.3390/hematolrep16010006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/13/2024] [Accepted: 01/16/2024] [Indexed: 01/23/2024] Open
Abstract
Mantle cell lymphoma (MCL) prognosis has significantly improved in recent years; however, the possible survival benefit of new treatment options should be evaluated outside of clinical trials. We investigated 73 consecutive MCL patients managed from 2006 to 2020. For younger patients <65 years old, the median PFS was 72 months and we reported a 2-year, 5-year, and 10-year PFS of 73%, 62%, and 41%; median OS was not reached and we reported a 2-year, 5-year, and 10-year OS of 88%, 82%, and 66%. For patients aged 75 years or older, the median PFS was 36 months and we reported a 2-year, 5-year, and 10-year PFS of 52%, 37%, and 37%; median OS was not reached and we reported a 2-year, 5-year, and 10-year OS of 72%, 55%, and 55%. The median PFS was significantly reduced for patients treated between 2006 and 2010 compared to patients treated between 2011 and 2015 (p = 0.04). Interestingly, there was a trend towards improved OS for patients treated between 2016 and 2020 compared to between 2006 and 2010 and between 2011 and 2015 (5-year OS was 91%, 44%, and 33%). These findings could be due to the introduction of BR as a first-line regimen for elderly patients and to the introduction of ibrutinib as a second-line regimen.
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Affiliation(s)
- Emanuele Cencini
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese, University of Siena, 53100 Siena, Italy; (M.F.); (A.D.); (S.F.); (B.E.V.); (G.L.N.); (A.F.); (M.B.)
| | - Natale Calomino
- Unit of General Surgery and Surgical Oncology, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy;
| | - Marta Franceschini
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese, University of Siena, 53100 Siena, Italy; (M.F.); (A.D.); (S.F.); (B.E.V.); (G.L.N.); (A.F.); (M.B.)
| | - Andreea Dragomir
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese, University of Siena, 53100 Siena, Italy; (M.F.); (A.D.); (S.F.); (B.E.V.); (G.L.N.); (A.F.); (M.B.)
| | - Sara Fredducci
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese, University of Siena, 53100 Siena, Italy; (M.F.); (A.D.); (S.F.); (B.E.V.); (G.L.N.); (A.F.); (M.B.)
| | - Beatrice Esposito Vangone
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese, University of Siena, 53100 Siena, Italy; (M.F.); (A.D.); (S.F.); (B.E.V.); (G.L.N.); (A.F.); (M.B.)
| | - Giulia Lucco Navei
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese, University of Siena, 53100 Siena, Italy; (M.F.); (A.D.); (S.F.); (B.E.V.); (G.L.N.); (A.F.); (M.B.)
| | - Alberto Fabbri
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese, University of Siena, 53100 Siena, Italy; (M.F.); (A.D.); (S.F.); (B.E.V.); (G.L.N.); (A.F.); (M.B.)
| | - Monica Bocchia
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese, University of Siena, 53100 Siena, Italy; (M.F.); (A.D.); (S.F.); (B.E.V.); (G.L.N.); (A.F.); (M.B.)
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Lee YP, Jung YJ, Cho J, Ko YH, Kim WS, Kim SJ, Yoon SE. A retrospective analysis of ibrutinib outcomes in relapsed or refractory mantle cell lymphoma. Blood Res 2023; 58:208-220. [PMID: 38151961 PMCID: PMC10758639 DOI: 10.5045/br.2023.2023208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/27/2023] [Accepted: 12/08/2023] [Indexed: 12/29/2023] Open
Abstract
Background While treatment strategies for mantle cell lymphoma (MCL) have evolved, patients often experience disease progression and require additional treatment therapies. Ibrutinib presents a promising option for relapsed or refractory MCL (RR-MCL). This study investigated real-world treatment outcomes of ibrutinib in patients with RR-MCL. Methods A single-center retrospective analysis investigated clinical characteristics and survival outcomes of patients with RR-MCL, treated with ibrutinib. Results Forty-two patients were included, with 16 received rituximab and bendamustine, and 26 receiving anthracycline-based regimens as front-line treatment. During a median follow-up of 46.0 months, the response rate to ibrutinib was 69%, with 12 CRs and 8 partial responses. Disease progression (54.8%) and adverse events (11.9%) were the primary reasons for discontinuation. Median progression-free survival (PFS) and overall survival (OS) were approximately 16.4 and 50.1 months, respectively. Patients older than 70 years (P=0.044 and P=0.006), those with splenomegaly (P=0.022 and P=0.006), and those with a high-risk simplified Mantle Cell Lymphoma International Prognostic Index (sMIPI) (P<0.001 and P<0.001) exhibited siginificantly inferior PFS and OS. Notably, patients with a high-risk sMIPI relapsed earlier. Post-ibrutinib treatment yilded an OS of 12.2 months, while clinical trial participants demonstrated superior survival compared to those receiving chemotherapy alone. Conclusion This study underscores the importance of considering patient characteristics before administering ibrutinib as salvage therapy. Early relapse was associated with poor outcomes, highlighting the need for novel therapeutic strategies.
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Affiliation(s)
- Yong-Pyo Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Ye Ji Jung
- Division of Hematology-Oncology, Departments of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Junhun Cho
- Division of Hematology-Oncology, Departments of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Hyeh Ko
- Division of Hematology-Oncology, Departments of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won Seog Kim
- Division of Hematology-Oncology, Departments of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Division of Hematology-Oncology, Departments of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea
| | - Seok Jin Kim
- Division of Hematology-Oncology, Departments of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Division of Hematology-Oncology, Departments of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea
| | - Sang Eun Yoon
- Division of Hematology-Oncology, Departments of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Yang P, Cai Q, Zhang W, Liu S, Liu H, Sun X, Dong Y, Xiao X, Wang J, Li Z, Huang W, Li L, Bao H, Yang W, Wang Y, Wang S, He J, Li X, Liu A, Jing H. Real-world treatment and outcome patterns of patients with mantle cell lymphoma in China: A large, multicenter retrospective analysis. Cancer Med 2023; 12:13204-13216. [PMID: 37148540 PMCID: PMC10315753 DOI: 10.1002/cam4.6009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 03/04/2023] [Accepted: 04/15/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND Mantle cell lymphoma (MCL) is an uncommon heterogeneous subtype of B cell non-Hodgkin lymphoma, and clinical features in MCL appear regional characteristics. MCL treatment opinions are not uniform between countries or regions within Asia and China, and Asian patient-specific data for MCL treatment are fewer. The study aims to explore the clinical characteristics, treatment patterns and prognosis of MCL patients in China. METHODS A total of 805 patients diagnosed with MCL between April 1999 and December 2019 at 19 comprehensive hospitals in China were included in this retrospective analysis. Kaplan-Meier method coupled with the log-rank test was used for univariate analysis, and COX proportional hazards model was used for multivariate analysis (MVA). p < 0.05 was consided statistically significant. All outputs were produced using R version 4.1.0. RESULTS The median age of the cohort was 60.0 years with a male-to-female ratio of 3.36:1. Five-year progression-free survival (PFS) and overall survival (OS) rates were 30.9% and 65.0%, respectively. High-intermediate/high-risk group according to MIPI-c, without high-dose cytarabine, lack of Auto-SCT as consolidation and maintenance treatment and SD/PD in initial treatment remained statistically relevant to poor PFS on MVA, and ki67 ≥50%, B symptoms, high-intermediate/high risk group according to MIPI-c, without high-dose cytarabine, lack of maintenance treatment, SD/PD in initial treatment and relapse/refractory state were independently associated with poorer OS on MVA. CONCLUSIONS First-line high dose cytarabine exposure, auto-SCT as consolidation therapy obtained survival benefits in Chinese population. Our study further confirmed the value of maintenance treatment and explored the application of new drug treatment and bendamustine in R/R MCL patients.
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Affiliation(s)
- Ping Yang
- Department of HematologyPeking University Third HospitalBeijingChina
| | - Qing‐qing Cai
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer MedicineSun Yat‐sen University Cancer CenterGuangzhouChina
| | - Wei Zhang
- Department of HematologyPeking Union Medical College HospitalBeijingChina
| | - Shuo‐zi Liu
- Department of HematologyPeking University Third HospitalBeijingChina
| | - Hui Liu
- Department of HematologyBeijing HospitalBeijingChina
| | - Xiu‐hua Sun
- Department of Medical OncologyThe Second Hospital of Dalian Medical UniversityDalianChina
| | - Yu‐jun Dong
- Department of HematologyPeking University First HospitalBeijingChina
| | - Xiu‐bin Xiao
- Senior Department of HematologyThe 5th Medical Center of PLA General HospitalBeijingChina
| | - Jing‐wen Wang
- Department of HematologyBeijing Tongren HospitalBeijingChina
| | - Zhen‐ling Li
- Department of HematologyChina‐Japan Friendship HospitalBeijingChina
| | - Wen‐rong Huang
- Senior Department of HematologyThe 5th Medical Center of PLA General HospitalBeijingChina
| | - Li‐hong Li
- Department of HematologyBeijing Tsinghua Changgung HospitalBeijingChina
| | - Hui‐zheng Bao
- Department of Medical OncologyJilin Cancer HospitalChangchunChina
| | - Wei Yang
- Department of HematologyShengjing Hospital of China Medical UniversityShenyangChina
| | - Ya‐lan Wang
- Department of Medical OncologyBaotou Cancer HospitalBaotouChina
| | - Shu‐ye Wang
- Department of HematologyThe First Hospital of Harbin Medical UniversityHarbinChina
| | - Juan He
- Department of HematologyThe First Hospital of China Medical UniversityShenyangChina
| | - Xiao‐ling Li
- Department of Medical OncologyLiaoning Cancer Hospital & InstituteShenyangChina
| | - Ai‐chun Liu
- Department of Hematology and Lymphatic MedicineHarbin Medical University Cancer HospitalHarbinChina
| | - Hong‐mei Jing
- Department of HematologyPeking University Third HospitalBeijingChina
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Baggio D, Wellard C, Chung E, Talaulikar D, Keane C, Opat S, Giri P, Minson A, Cheah CY, Armytage T, Lee D, Chong G, Johnston A, Cochrane T, Waters N, Hamad N, Wood EM, Hawkes EA. Australian experience with ibrutinib in patients with relapsed/refractory mantle cell lymphoma: a study from the Lymphoma and Related Diseases Registry. Leuk Lymphoma 2023; 64:621-627. [PMID: 38376128 DOI: 10.1080/10428194.2022.2157676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022]
Abstract
Bruton's tyrosine kinase inhibitors (BTKi) have an established role in the management of patients with relapsed/refractory mantle cell lymphoma (MCL). However, scant data exist on outcomes of patients ineligible for clinical trials testing these therapies. We describe a contemporary cohort of relapsed/refractory MCL patients from the Australasian Lymphoma and Related Diseases Registry treated with ibrutinib December 2014 until July 2018, to determine the proportion potentially eligible for original trials, reasons for ineligibility and survival outcomes. Of 44 patients, 41% met one or more exclusion criteria from previous phase II/III MCL BTKi studies. Median progression-free and overall survival were 13.7 months (95% CI 6.2-28.1) and 15.6 months (95% CI 10.8-29.6) respectively and were shorter in patients excluded from clinical trials based on ECOG ≥2. Ibrutinib has demonstrable clinical effectiveness in a population enriched for unfit and trial-ineligible patients, and a need for more inclusive enrollment criteria in future BTKi studies is highlighted.
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Affiliation(s)
- Diva Baggio
- Olivia Newton John Cancer Research and Wellness Centre, Austin Health, Heidelberg, Australia
| | - Cameron Wellard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Eliza Chung
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Dipti Talaulikar
- Canberra Health, Australian Capital Territory, Canberra, Australia
| | - Colm Keane
- Princess Alexandra Hospital, Woolloongabba, Australia
| | - Stephen Opat
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Monash Health, Clayton, Australia
| | | | - Adrian Minson
- Peter MacCallum Cancer Centre, Melbourne, Australia
- The Royal Melbourne Hospital, Parkville, Australia
| | | | | | | | - Geoffrey Chong
- Ballarat Regional Integrated Cancer Centre, Ballarat, Australia
| | | | - Tara Cochrane
- Gold Coast University Hospital, Southport, Australia
| | - Neil Waters
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Nada Hamad
- St Vincent's Health, Darlinghurst, Australia
| | - Erica M Wood
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Eliza A Hawkes
- Olivia Newton John Cancer Research and Wellness Centre, Austin Health, Heidelberg, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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5
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Obr A, Benesova K, Janikova A, Mocikova H, Belada D, Hruskova A, Vockova P, Salek D, Sykorova A, Furst T, Malarikova D, Papajik T, Trneny M, Klener P. Ibrutinib in mantle cell lymphoma: a real-world retrospective multi-center analysis of 77 patients treated in the Czech Republic. Ann Hematol 2023; 102:107-115. [PMID: 36369497 PMCID: PMC9807478 DOI: 10.1007/s00277-022-05023-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 10/19/2022] [Indexed: 11/12/2022]
Abstract
Ibrutinib revolutionized therapy for relapsed/refractory (R/R) mantle cell lymphoma (MCL). Real-world data on the outcome of unselected patients are still limited. We analyzed 77 R/R MCL patients receiving ibrutinib with at least one prior systemic anti-lymphoma therapy. After a median follow-up of 14.0 months, 56 patients relapsed/progressed, and 45 died. The overall response rate was 66%, with 31% of complete metabolic remissions on PET/CT. The median progression-free and overall survival (OS) rates were 10.3 and 23.1 months, respectively. The median OS from ibrutinib failure was 3.7 months. High proliferation rate by Ki67 (≥ 30%) and two or more previous therapy lines both negatively correlated with outcome (HR = 2.2, p = 0.04, and HR = 2.06, p = 0.08, respectively). Female gender borderline correlated with better outcome (HR = 0.53, p = 0.08). In multivariate analysis, Ki67 and response to ibrutinib both correlated with OS (p < 0.05). Importantly, ibrutinib appeared to better control nodal and extranodal lymphoma than bone marrow (BM) involvement. From 20 patients with detectable BM infiltration (before ibrutinib initiation) achieving complete (n = 13) or partial (n = 7) metabolic remission, none achieved remission in BM. We confirmed good efficacy of ibrutinib in unselected heavily pre-treated MCL patients. Our findings support the use of a combination of ibrutinib and rituximab in patients with BM involvement.
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Affiliation(s)
- Ales Obr
- Department of Haemato-Oncology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Republic
| | - Katerina Benesova
- First Department of Internal Medicine–Department of Haematology, University General Hospital and First Faculty of Medicine, Charles University, U Nemocnice 499/2, Prague, 12808 Czech Republic
| | - Andrea Janikova
- Department of Haematology and Oncology, University Hospital, Brno, Czech Republic
| | - Heidi Mocikova
- Department of Internal Medicine and Haematology, Faculty Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - David Belada
- 4th Department of Internal Medicine–Haematology, University Hospital and Faculty of Medicine, Hradec Kralove, Czech Republic
| | - Andrea Hruskova
- Department of Haemato-Oncology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Republic
| | - Petra Vockova
- First Department of Internal Medicine–Department of Haematology, University General Hospital and First Faculty of Medicine, Charles University, U Nemocnice 499/2, Prague, 12808 Czech Republic
| | - David Salek
- Department of Haematology and Oncology, University Hospital, Brno, Czech Republic
| | - Alice Sykorova
- 4th Department of Internal Medicine–Haematology, University Hospital and Faculty of Medicine, Hradec Kralove, Czech Republic
| | - Tomas Furst
- Department of Mathematical Analysis and Applications of Mathematics, Faculty of Science, Palacky University, Olomouc, Czech Republic
| | - Diana Malarikova
- First Department of Internal Medicine–Department of Haematology, University General Hospital and First Faculty of Medicine, Charles University, U Nemocnice 499/2, Prague, 12808 Czech Republic
| | - Tomas Papajik
- Department of Haemato-Oncology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Republic
| | - Marek Trneny
- First Department of Internal Medicine–Department of Haematology, University General Hospital and First Faculty of Medicine, Charles University, U Nemocnice 499/2, Prague, 12808 Czech Republic
| | - Pavel Klener
- First Department of Internal Medicine–Department of Haematology, University General Hospital and First Faculty of Medicine, Charles University, U Nemocnice 499/2, Prague, 12808 Czech Republic ,Institute of Pathological Physiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
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Horgan D, Walewski J, Aurer I, Visco C, Giné E, Fetica B, Jerkeman M, Kozaric M, da Silva MG, Dreyling M. Tackling Mantle Cell Lymphoma in Europe. Healthcare (Basel) 2022; 10:1682. [PMID: 36141294 PMCID: PMC9498856 DOI: 10.3390/healthcare10091682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/24/2022] [Accepted: 08/31/2022] [Indexed: 11/17/2022] Open
Abstract
An expert panel convened by the European Alliance for Personalized Medicine (EAPM) reflected on achievements and outstanding challenges in Europe in mantle cell lymphoma (MCL). Through the prism of member state experience, the panel noted advances in outcomes over the last decade, but highlighted issues constituting barriers to better care. The list notably included availability of newer treatments, infrastructure and funding for related testing, and shortages of relevant skills and of research support. The prospect of improvements was held to reside in closer coordination and cooperation within and between individual countries, and in changes in policy and scale of investment at both national and EU levels.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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8
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Eyre TA, Cheah CY, Wang ML. Therapeutic options for relapsed/refractory mantle cell lymphoma. Blood 2022; 139:666-77. [PMID: 34679161 DOI: 10.1182/blood.2021013326] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 10/20/2021] [Indexed: 02/05/2023] Open
Abstract
Mantle cell lymphoma (MCL) is an uncommon subtype of non-Hodgkin lymphoma in which immunochemotherapy, with or without high-dose therapy, and autologous stem cell transplantation remain standard frontline therapies. Despite their clear efficacy, patients inevitably relapse and require subsequent therapy. In this review, we discuss the key therapeutic approaches in the management of relapsed MCL, covering in depth the data supporting the use of covalent Bruton tyrosine kinase (BTK) inhibitors at first or subsequent relapse. We describe the outcomes of patients progressing through BTK inhibitors and discuss the mechanisms of covalent BTKi resistance and treatment options after covalent treatment with BTKi. Options in this setting may depend on treatment availability, patient's and physician's preference, and the patient's age and comorbidity status. We discuss the rapid recent development of anti-CD19 chimeric antigen receptor T-cell therapy, as well as the utility of allogenic stem cell transplantation and novel therapies, such as noncovalent, reversible BTK inhibitors; ROR1 antibody drug conjugates; and bispecific antibodies.
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