Mantle cell lymphoma treatment options for elderly/unfit patients: A systematic review

Till, Kathleen J.; Alnassfan, Tahera; Cox-Pridmore, Megan; Taktak, Azzam

doi:10.1002/jha2.311

Cited by 7 publications

(10 citation statements)

References 66 publications

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“…Drug resistance in the treatment of MCL with ibrutinib may also be a factor. 34,35 Our results suggested that VR-CAP regimen (SUCRA 0.89, PbBT 63%) may be the most effective treatment regimen for prolonged OS in MCL patients. This treatment strategy was to replace vincristine with bortezomib on the basis of R-CHOP regimen.…”

Section: Discussionmentioning

confidence: 75%

Efficacy of front‐line immunochemotherapy for transplant‐ineligible mantle cell lymphoma: A network meta‐analysis of randomized controlled trials

et al. 2023

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BackgroundThere is no standard first‐line immunochemotherapy regimen for transplant‐ineligible patients with mantle cell lymphoma (MCL) currently, and the efficacy of various treatment remains unclear.MethodsWe conducted a Bayesian network meta‐analysis (NMA) of all eligible randomized controlled trials. Pairwise comparisons and ranking of different first‐line treatment options were performed.ResultsNine studies were included in the NMA, involving a total of 2897 MCL patients. The BR‐Ibrutinib+R regimen showed the best progression‐free survival (PFS), with a surface under the cumulative ranking curve (SUCRA) of 0.89 and probability of being the best treatment (PbBT) of 69%. The VR‐CAP regimen was the most potential intervention to improve overall survival (OS), with a SUCRA of 0.89 and PbBT of 63%. Compared with the R‐CHOP regimen, the BR regimen achieved a better PFS (hazard ratio [HR] 0.45 [95% credible interval 0.2–0.96]). The BR‐Ibrutinib+R regimen (HR 0.14 [0.02–0.99]), BR+R regimen (HR 0.19 [0.034–0.99]), and BR regimen (HR 0.3 [0.08–1.03]) were superior to CHOP regimen with better PFS. The R‐FC regimen (HR 2.27 [1.01–5.21]) or FC regimen (HR 3.17 [1.15–8.71]) was inferior to the VR‐CAP regimen with a worse OS.ConclusionsOur study presents the most promising first‐line treatment strategy for transplant‐ineligible MCL patients in terms of PFS and OS, which provides innovative treatment strategy for MCL treatment.

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Section: Discussionmentioning

confidence: 75%

Efficacy of front‐line immunochemotherapy for transplant‐ineligible mantle cell lymphoma: A network meta‐analysis of randomized controlled trials

et al. 2023

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“…Research continues, focused particularly on relapsed and high-risk patients. There are different treatment options for younger patients without comorbidities and for elderly fit patients [ 32 ]. High-dose therapy and autologous stem-cell rescue and high-dose cytarabine in younger patients has shown benefits, as has maintenance rituximab and bendamustine in older patients.…”

Section: Situation Reportmentioning

confidence: 99%

Tackling Mantle Cell Lymphoma in Europe

Horgan¹,

Walewski

Aurer

et al. 2022

Healthcare

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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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“…MCL is an aggressive B-cell non-Hodgkin's lymphoma (B-NHL) which is incurable with current treatment options, and overall survival (OS) ranges between 3 and 5 years [1][2][3][4] . MCL is genetically characterised by the t11;14 translocation which results in overexpression of cyclin D1.…”

mentioning

confidence: 99%

“…MCL is genetically characterised by the t11;14 translocation which results in overexpression of cyclin D1. Although the translocation and consequence overexpression of cyclin D1 is not sufficient to induce lymphomagenesis it probably facilitates the process by deregulating the cell cycle [1][2][3][4] . It has been long been known that MCL has two distinct clinical entities described as classical (nodal) MCL, and a leukaemic (non-nodal) variant.…”

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confidence: 99%

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Roles of PI3Kγ and PI3Kδ in mantle cell lymphoma proliferation and migration contributing to efficacy of the PI3Kγ/δ inhibitor duvelisib

Till

Abdullah

Alnassfan

et al. 2023

Sci Rep

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Mantle cell lymphoma (MCL) is an aggressive B-cell non-Hodgkin lymphoma that is incurable with existing therapies, and therefore presents a significant unmet clinical need. The ability of this disease to overcome therapy, including those that target the B cell receptor pathway which has a pathogenic role in MCL, highlights the need to develop new treatment strategies. Herein, we demonstrate that a distinguishing feature of lymph node resident MCL cells is the expression of phosphatidylinositol 3-kinase γ (PI3Kγ), a PI3K isoform that is not highly expressed in other B cells or B-cell malignancies. By exploring the role of PI3K in MCL using different PI3K isoform inhibitors, we provide evidence that duvelisib, a dual PI3Kδ/γ inhibitor, has a greater effect than PI3Kδ- and PI3Kγ-selective inhibitors in blocking the proliferation of primary MCL cells and MCL cell lines, and in inhibiting tumour growth in a mouse xenograft model. In addition, we demonstrated that PI3Kδ/γ signalling is critical for migration of primary MCL cells and cell lines. Our data indicates that aberrant expression of PI3Kγ is a critical feature of MCL pathogenesis. Thus, we suggest that the dual PI3Kδ/γ duvelisib would be effective for the treatment of mantle cell lymphoma.

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Mantle cell lymphoma treatment options for elderly/unfit patients: A systematic review

Cited by 7 publications

References 66 publications

Efficacy of front‐line immunochemotherapy for transplant‐ineligible mantle cell lymphoma: A network meta‐analysis of randomized controlled trials

Efficacy of front‐line immunochemotherapy for transplant‐ineligible mantle cell lymphoma: A network meta‐analysis of randomized controlled trials

Tackling Mantle Cell Lymphoma in Europe

Roles of PI3Kγ and PI3Kδ in mantle cell lymphoma proliferation and migration contributing to efficacy of the PI3Kγ/δ inhibitor duvelisib

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