Outcomes in 370 patients with mantle cell lymphoma treated with ibrutinib: a pooled analysis from three open‐label studies

Abstract

Ibrutinib is highly active in treating mantle cell lymphoma (MCL), an aggressive B-cell lymphoma. We pooled data from three ibrutinib studies to explore the impact of baseline patient characteristics on treatment response. Patients with relapsed/refractory MCL (n = 370) treated with ibrutinib had an objective response rate (ORR) of 66% (20% complete response; 46% partial response); median duration of response (DOR), progression-free survival (PFS) and overall survival (OS) were 18.6, 12.8 and 25.0 months, respectively. Univariate analyses showed patients with one versus >one prior line of therapy had longer OS. Multivariate analyses identified that one prior line of therapy affected PFS; Eastern Cooperative Oncology Group (ECOG) performance status, simplified MCL international prognostic index (sMIPI) score, bulky disease, and blastoid histology affected OS and PFS. Patients with blastoid versus non-blastoid histology had similar time to best response, but lower ORR, DOR, PFS and OS. OS and PFS were longer in patients with better sMIPI, patients with ECOG performance status 0–1, non-bulky disease and non-blastoid histology. Additionally, the proportion of patients with poor prognostic factors increased with increasing lines of therapy. Together, results suggest that patient outcomes following treatment failure with ibrutinib are related to the natural biological evolution of the disease.

Mantle cell lymphoma: 2019 update on the diagnosis, pathogenesis, prognostication, and management

“…Patients who received ibrutinib as first salvage therapy had a superior response rate 77% (37% CR) and longer duration of response (36 months) compared to those who received ibrutinib in subsequent lines of therapy. Furthermore, non‐blastoid cytomorphology, low Ki‐67% (<30%), and TP53 wild‐type subsets exhibited better outcomes with ibrutinib compared to blastoid, high Ki‐67%, and TP53 ‐mutated subsets …”

Time to progression of mantle cell lymphoma after high‐dose cytarabine‐based regimens defines patients risk for death

“…However, no plateau in survival curves has been observed, and virtually all patients will experience disease recurrence for which no standard therapy exists (Dreyling et al , ). Allogeneic stem cell transplantation (AlloSCT) remains the only option with curative potential (Robinson et al , ; Tessoulin et al , ; Rule et al , ).…”

Guideline for the management of mantle cell lymphoma

“…Ibrutinib can cross the blood brain barrier and is effective in CNS relapse (Tucker et al , ). The earlier ibrutinib is used the more effective it is (Rule et al , ). Trials are on‐going, assessing a wide range of ibrutinib combination therapies both at relapse and front line.…”