A retrospective study of 404 consecutive patients with mantle cell lymphoma (MCL) treated between 2000 and 2014 showed that median overall survival (OS) and progression-free survival (PFS) were 9.7 and 4.0 years, respectively after first line treatment.
In total, 386 patients received first-line treatment, 204 received second-line treatment, 115 received third-line treatment, 72 received fourth-line treatment, and 88 received 5 to 9 lines of treatment.
After second-line therapy, median OS and PFS were 41.1 and 14.0 months, respectively. Median OS and PFS after third-line therapy were 25.2 and 6.5 months, respectively, and 14.4 and 5.0 months, respectively, after fourth-line therapy. Early treatment failure, including failure to achieve complete remission or relapse in less than 12 months after first-line regimens, was significantly associated with worse OS (5.9 vs. 2.5 years; p<0.01).
Chemotherapy induction followed by hematopoietic cell transplantation (HCT) was offered to 46 (n=179) of patients. In patients <65 years, HCT-based front-line regimens were associated with improved PFS compared with non-HCT regimens (median PFS: 86.2 vs. 40.0 months; p<0.01), with a trend toward longer OS (median OS: 165.0 vs. 120.0 months; p=0.06).
Patients who received therapy with ibrutinib experienced increased survival rates when given as second-line treatment compared with later lines of treatment (OS: hazard ratio [HR], 0.27; P <.01; PFS: HR, 0.52; P =.03).
The researchers concluded that their study demonstrates a continuing clinical need for novel therapeutic approaches particularly in patients with MCL with early treatment failure or who experience multiple relapses.
Kumar A, et al. Blood Cancer Journal
Shorter response duration and survival after each treatment relapse in MCL
Jul 2019