Outcomes in first relapsed-refractory younger patients with mantle cell lymphoma: results from the MANTLE-FIRST study
Autor: | Guido Gini, Piero Maria Stefani, Luca Nassi, Tommasina Perrone, Simon Rule, Monica Balzarotti, Cristina Tecchio, Valentina Bozzoli, Antonello Sica, Luca Arcaini, Alessandro Re, Carlo Visco, Annalisa Chiappella, Maria Christina Cox, Simone Ferrero, Roberta Sciarra, Maria Chiara Tisi, Mauro Krampera, Chiara Rusconi, Andrea Evangelista, Vittorio Ruggero Zilioli, Maria Isabel Alvarez De Celis, Alice Di Rocco, Elsa Pennese, Ana Marin-Niebla, Rory McCulloch, Alberto Fabbri, Umberto Vitolo, Lucia Morello, Francesca Maria Quaglia, Stefan Hohaus, Valentina Polli, Luca Petrucci |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
0301 basic medicine
Oncology Male Cancer Research Lymphoma Drug Resistance Salvage therapy Lymphoma Mantle-Cell Adult Aged Antineoplastic Combined Chemotherapy Protocols Drug Resistance Neoplasm Female Follow-Up Studies Humans International Agencies Middle Aged Neoplasm Recurrence Local Prognosis Retrospective Studies Survival Rate Young Adult Salvage Therapy chemistry.chemical_compound 0302 clinical medicine Medicine B-cell lymphoma education.field_of_study Hematology Local 030220 oncology & carcinogenesis Ibrutinib outcome relapse/refractory medicine.drug medicine.medical_specialty mantle cell lymphoma Population 03 medical and health sciences Internal medicine Mantle-First education Survival rate business.industry Mantle-Cell medicine.disease 030104 developmental biology Neoplasm Recurrence chemistry Cytarabine Neoplasm Mantle cell lymphoma business |
Popis: | Patients with mantle cell lymphoma (MCL) that fail induction treatment represent a difficult-to-treat population, where no standard therapy exists. We evaluated outcomes in patients with first relapsed-refractory (r/r) MCL after upfront high dose cytarabine including standard regimens. Overall survival (OS-2) and progression-free survival (PFS-2) were estimated from the time of salvage therapy. The previously described threshold of 24 months was used to define patients as early- or late-progressors (POD). Overall, 261 r/r MCL patients were included. Second-line regimens consisted of rituximab-bendamustine (R-B, 21%), R-B and cytarabine (R-BAC, 29%), ibrutinib (19%), and others (31%). The four groups were balanced in terms of clinicopathological features. Adjusting for age and early/late-POD, patients treated with R-BAC had significantly higher complete remission (63%) than comparators. Overall, Ibrutinib and R-BAC were associated with improved median PFS-2 [24 and 25 months, respectively], compared to R-B (13) or others (7). In patients with early-POD (n = 127), ibrutinib was associated with inferior risk of death than comparators (HR 2.41 for R-B, 2.17 for others, 2.78 for R-BAC). In patients with late-POD (n = 134), no significant differences were observed between ibrutinib and bendamustine-based treatments. Ibrutinib was associated with improved outcome in early-POD patients. |
Databáze: | OpenAIRE |
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