Clinical efficacy and safety of first-line treatments in patients with mantle cell lymphoma: A systematic literature review

Monga, Neerav; Tam, Constantine S.; Garside, Jamie; Davids, Matthew S.; Ward, Katherine N.; Quigley, Joan; Parisi, Lori; Tapprich, Christoph

doi:10.1016/j.critrevonc.2020.103212

Cited by 9 publications

(8 citation statements)

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Section: Introductionmentioning

confidence: 87%

“…8 The median overall survival (OS) varied from 40 to 70 months in older patients and from 53 to 152 months in younger patients frequently treated with ASCT. 6 Retrospective studies from academic institutions demonstrated similar outcomes to prospective trials among patients treated similarly. 9 We evaluated treatment patterns and outcomes in 1L MCL and assessed the impact of ASCT in patients age , 65 years and MR after BR or R-CHOP in two large independent real-world cohorts.…”

Section: Introductionmentioning

confidence: 87%

“…3,4 Current guidelines acknowledge lack of evidence from prospective trials for the use of MR after BR. [3][4][5] A systematic review of clinical trials of commonly used first-line (1L) MCL regimens 6 reported a median progression-free survival (PFS) ranging from 16.6 months with R-CHOP alone 7 to 109.2 months with R-CHOP/rituximab plus dexamethasone, cytarabine and platinum followed by ASCT. 8 The median overall survival (OS) varied from 40 to 70 months in older patients and from 53 to 152 months in younger patients frequently treated with ASCT.…”

Section: Introductionmentioning

confidence: 99%

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Treatment Outcomes and Roles of Transplantation and Maintenance Rituximab in Patients With Previously Untreated Mantle Cell Lymphoma: Results From Large Real-World Cohorts

Martin

Cohen

Wang

et al. 2023

JCO

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PURPOSE Commonly used first-line (1L) treatments for mantle cell lymphoma include high-dose cytarabine-based induction followed by autologous stem-cell transplant (ASCT) for younger patients and several chemoimmunotherapy regimens for older patients. Continuous debates exist on the role of ASCT in younger patients and maintenance rituximab (MR) after bendamustine plus rituximab (BR). METHODS Retrospective data from 4,216 patients with mantle cell lymphoma in the Flatiron Health electronic record-derived deidentified database diagnosed between 2011 and 2021, mostly in US community oncology settings, were evaluated for treatment patterns and outcomes. The efficacy findings with ASCT and MR were validated in an independent cohort of 1,168 patients from 12 academic centers. RESULTS Among 3,614 patients with documented 1L treatment, BR was the most used. Among 1,265 patients age < 65 years, 30.5% received cytarabine-based induction and 23.5% received ASCT. There was no significant association between ASCT and real-world time to next treatment (hazard ratio [HR] 0.84; 95% CI, 0.68 to 1.03; P = .10) or overall survival (HR 0.86; 95% CI, 0.63 to 1.18; P = .4) among ASCT-eligible patients. Among MR-eligible patients, MR after BR versus BR alone was associated with a longer real-world time to next treatment (HR 1.96; 95% CI, 1.61 to 2.38; P < .001) and overall survival (HR 1.51; 95% CI, 1.19 to 1.92; P < .001). The efficacy findings were consistent in the validation cohort. CONCLUSION In this large cohort of patients treated primarily in the US community setting, only one in four young patients received cytarabine or ASCT consolidation, suggesting the need to develop treatments that can be delivered effectively in routine clinical practice. Together with the validation cohort, data support future clinical trials exploring regimens without ASCT consolidation in young patients, whereas MR should be considered for patients after 1L BR and rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone.

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Section: Introductionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Treatment Outcomes and Roles of Transplantation and Maintenance Rituximab in Patients With Previously Untreated Mantle Cell Lymphoma: Results From Large Real-World Cohorts

Martin

Cohen

Wang

et al. 2023

JCO

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“…This disease generally involves extranodal sites such as blood, bone marrow, and the gastrointestinal tract 4,5 . Most patients with newly diagnosed MCL are older and are ineligible candidates for aggressive therapy and autologous stem‐cell transplantation, which results in poor prognosis 6–9 . For those untreated patients ineligible for intensive therapy, current guidelines recommend less‐aggressive first‐line therapy, as bendamustine plus rituximab (BR), rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R‐CHOP), or bortezomib, rituximab, cyclophosphamide, doxorubicin, and prednisone (VR‐CAP) 10–12 .…”

Section: Introductionmentioning

confidence: 99%

“…4,5 Most patients with newly diagnosed MCL are older and are ineligible candidates for aggressive therapy and autologous stem-cell transplantation, which results in poor prognosis. [6][7][8][9] For those untreated patients ineligible for intensive therapy, current guidelines recommend less-aggressive first-line therapy, as bendamustine plus rituximab (BR), rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), or bortezomib, rituximab, cyclophosphamide, doxorubicin, and prednisone (VR-CAP). [10][11][12] Recently, in the international, randomized, double-blind, Phase 3 SHINE trial, the ibrutinib + BR (Ibru + BR) regimen significantly prolonged progression-free survival (PFS), and had a good risk-benefit profile, 13 when compared to BR.…”

Section: Introductionmentioning

confidence: 99%

Superiority of ibrutinib plus bendamustine and rituximab in newly diagnosed patients with mantle‐cell lymphoma ineligible for intensive therapy: A network meta‐analysis

Sheng

Wang

2023

European J of Haematology

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Because of lacking of head-to-head comparison among recently effective novel agents' combination regimens for newly diagnosed patients with mantle-cell lymphoma (MCL) who are ineligible for intensive therapy like autologous stem-cell transplantation, the optimal option for these patients still remains undefined. We searched relevant published reports. Three randomized controlled trials with 1459 subjects were identified. In the network meta-analysis, ibrutinib plus bendamustine and rituximab (Ibru + BR) significantly improved progression-free survival (PFS) when compared to bortezomib, rituximab, cyclophosphamide, doxorubicin, and prednisone (VR-CAP; hazard ratio [HR]: 0.55, p = .03) and rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP; HR: 0.35, p < .001) for newly diagnosed patients with MCL ineligible for intensive therapy. Among these first-line treatment regimens (Ibru + BR, VR-CAP, R-CHOP, and BR), Ibru + BR had the highest probability of 94.9% to be the best intervention in PFS analysis. No significant difference was found in adverse events analysis. Our data indicated that Ibru + BR seemed to prolong the PFS when compared to VR-CAP and R-CHOP for newly diagnosed patients with MCL ineligible for intensive therapy. Considering our limits, prospective clinical trials directly comparing these regimens are warranted.

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Outcomes of pirtobrutinib for relapsed/refractory mantle cell lymphoma in compassionate use program in Europe

Aydilek,

Wulf,

Schwarz

et al. 2024

Cancer Medicine

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BackgroundMantle cell lymphoma (MCL) is a type of B‐cell lymphoma that is currently incurable. Pirtobrutinib shows promising response rates in heavily pretreated MCL patients according to the approval study, but the real‐world data are scarce.MethodsIn this study, we retrospectively analyzed the efficacy and safety profile of pirtobrutinib in 10 relapsed/refractory MCL patients from compassionate use program (CUP).ResultsOn average, the patients underwent three lines of systemic therapy prior to pirtobrutinib and were predominantly BTKi exposed (9/10). The best overall response rate (BORR) was 67%. In a median follow‐up of 8.6 months, the mean duration of response (DOR), progression‐free survival (PFS), and overall survival (OS) were not reached. No new safety signals were documented.ConclusionsIn summary, pirtobrutinib represented a safe and effective treatment option in a small real‐world population.

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Clinical efficacy and safety of first-line treatments in patients with mantle cell lymphoma: A systematic literature review

Cited by 9 publications

References 50 publications

Treatment Outcomes and Roles of Transplantation and Maintenance Rituximab in Patients With Previously Untreated Mantle Cell Lymphoma: Results From Large Real-World Cohorts

Treatment Outcomes and Roles of Transplantation and Maintenance Rituximab in Patients With Previously Untreated Mantle Cell Lymphoma: Results From Large Real-World Cohorts

Superiority of ibrutinib plus bendamustine and rituximab in newly diagnosed patients with mantle‐cell lymphoma ineligible for intensive therapy: A network meta‐analysis

Outcomes of pirtobrutinib for relapsed/refractory mantle cell lymphoma in compassionate use program in Europe

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