Treatment Outcomes and Survival Patterns of Asian Patients With Relapsed/Refractory Mantle Cell Lymphoma

Abstract

Background Mantle cell lymphoma (MCL) is widely considered an incurable malignancy even with current therapies and relapsed/refractory (R/R) disease to primary treatment remains common. With improved treatment guidelines and the advent of novel agents, patients are increasingly being treated with more lines of regimens. However, outcomes after each line of treatment remain poorly characterized, especially in the Asian population. In this paper, we described the survival outcomes in a group of R/R MCL patients. Methods We retrospectively studied 35 patients with R/R MCL between 1998 and 2020 at the National Cancer Centre Singapore. Patients were followed longitudinally throughout their disease course. Overall survival (OS) and progression-free survival (PFS) were determined by the Kaplan-Meier method. Results The median OS and PFS from diagnosis were 105 and 40 months, respectively. After first relapse, the median OS and PFS were 52 and 19 months, post-second relapse 32 and 8 months, and post-third relapse 12 and 6 months, respectively. Patients older than 65 years at first relapse had shorter survival (median OS: 22 vs. 55 months, P = 0.0417; median PFS: 9 vs. 29 months, P = 0.001). Early treatment failure after first line therapy was also associated with worse survival outcomes (median OS: 13 vs. 55 months, P < 0.001; median PFS: 9 vs. 26 months, P < 0.001). Conclusion With each relapse, survival outcomes for patients with MCL are worse. Novel treatment and contemporary outcomes of R/R MCL are encouraging and support the need for continued research in this area.

Long‐term outcomes of second‐line versus later‐line zanubrutinib treatment in patients with relapsed/refractory mantle cell lymphoma: An updated pooled analysis

“…All these results showed more sustained and durable survival outcomes over long‐term follow‐ups in R/R MCL patients treated with BTK inhibitors in the early line than in the later lines. These findings hold considerable importance as it is known that the survival outcomes in MCL become worse with every relapse and increasing line of treatment 22 . The previous studies have indicated that the earlier initiated treatment of MCL patients could lead to a survival benefit.…”

“…These findings hold considerable importance as it is known that the survival outcomes in MCL become worse with every relapse and increasing line of treatment. 22 The previous studies have indicated that the earlier initiated treatment of MCL patients could lead to a survival benefit. Therefore, the optimal place for the initiation of BTK inhibitor therapy in the treatment of patients with R/R MCL to maximize the survival benefits remains a matter of interest.…”