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
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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