Patients with mantle cell lymphoma failing ibrutinib are unlikely to respond to salvage chemotherapy and have poor outcomes.

Autor:	Cheah CY; Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, Houston, USA., Chihara D; Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, Houston, USA., Romaguera JE; Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, Houston, USA., Fowler NH; Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, Houston, USA., Seymour JF; Department of Haematology, Peter MacCallum Cancer Center, Melbourne; Department of Haematology, University of Melbourne, Melbourne, Australia., Hagemeister FB; Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, Houston, USA., Champlin RE; Department of Stem Cell Transplantation, University of Texas MD Anderson Cancer Center, Houston, USA., Wang ML; Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: miwang@mdanderson.org.
Jazyk:	angličtina
Zdroj:	Annals of oncology : official journal of the European Society for Medical Oncology [Ann Oncol] 2015 Jun; Vol. 26 (6), pp. 1175-1179. Date of Electronic Publication: 2015 Feb 23.
DOI:	10.1093/annonc/mdv111
Abstrakt:	Background: Although ibrutinib is highly effective in patients with relapsed/refractory mantle cell lymphoma (MCL), a substantial proportion of patients have resistant disease. The subsequent outcomes of such patients are unknown. Patients and Methods: We carried out a retrospective review of all patients with MCL treated with ibrutinib at MD Anderson Cancer Center between January 2011 and January 2014 using pharmacy and clinical databases. Patients who had discontinued ibrutinib for any reason were included in the study. Results: We identified 42 patients with MCL who discontinued therapy due to disease progression on treatment (n = 28), toxicity (n = 6), elective stem-cell transplant in remission (n = 4) or withdrawn consent (n = 4). The median age was 69 years, 35 (83%) were male; the median number of prior treatments was 2 (range 1-8) and the median time from initial diagnosis of MCL to commencing ibrutinib was 3.0 (range 0.5-15.5) years. Patients had received a median of 6.5 (range 1-43) cycles of ibrutinib. Among 31 patients who experienced disease progression following ibrutinib and underwent salvage therapy, the overall and complete response rates were 32% and 19%, respectively. After a median follow-up of 10.7 (range 2.4-38.9) months from discontinuation of ibrutinib, the median overall survival (OS) among patients with disease progression was 8.4 months. By univariate analysis, elevated serum lactate dehydrogenase at progression was associated with inferior OS. Conclusion: The outcome of patients with MCL who experience disease progression following ibrutinib therapy is poor, with both low response rates to salvage therapy and short duration of responses. Further studies to better understand and overcome ibrutinib resistance are urgently needed. (© The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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