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Clinical outcomes for ibrutinib in relapsed or refractory mantle cell lymphoma in real‐world experience

Ibrutinib is highly effective in patients with relapsed or refractory mantle cell lymphoma (MCL) in major clinical trials. Although there has been a dramatic improvement in survival outcomes in the salvage setting, nonresponders to ibrutinib have a bleak prognosis. Therefore, this retrospective stud...

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Autores principales: Jeon, Young‐Woo, Yoon, Seugyun, Min, Gi June, Park, Sung‐Soo, Park, Silvia, Yoon, Jae‐Ho, Lee, Sung‐Eun, Cho, Byung‐Sik, Eom, Ki‐Seong, Kim, Yoo‐Jin, Kim, Hee‐Je, Lee, Seok, Min, Chang‐Ki, Lee, Jong Wook, Cho, Seok‐Goo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6853811/
https://www.ncbi.nlm.nih.gov/pubmed/31560165
http://dx.doi.org/10.1002/cam4.2565
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author Jeon, Young‐Woo
Yoon, Seugyun
Min, Gi June
Park, Sung‐Soo
Park, Silvia
Yoon, Jae‐Ho
Lee, Sung‐Eun
Cho, Byung‐Sik
Eom, Ki‐Seong
Kim, Yoo‐Jin
Kim, Hee‐Je
Lee, Seok
Min, Chang‐Ki
Lee, Jong Wook
Cho, Seok‐Goo
author_facet Jeon, Young‐Woo
Yoon, Seugyun
Min, Gi June
Park, Sung‐Soo
Park, Silvia
Yoon, Jae‐Ho
Lee, Sung‐Eun
Cho, Byung‐Sik
Eom, Ki‐Seong
Kim, Yoo‐Jin
Kim, Hee‐Je
Lee, Seok
Min, Chang‐Ki
Lee, Jong Wook
Cho, Seok‐Goo
author_sort Jeon, Young‐Woo
collection PubMed
description Ibrutinib is highly effective in patients with relapsed or refractory mantle cell lymphoma (MCL) in major clinical trials. Although there has been a dramatic improvement in survival outcomes in the salvage setting, nonresponders to ibrutinib have a bleak prognosis. Therefore, this retrospective study was conducted to identify the most appropriate therapeutic strategy and prognosis‐related factors to predict the response of patients with relapsed or refractory MCL to ibrutinib monotherapy. Thirty‐three consecutive refractory or relapsed MCL patients treated with ibrutinib were analyzed in this study. The median overall survival (OS) and progression‐free survival (PFS) after initiation of ibrutinib were 35.1 months and 27.4 months, respectively. Risk factor analysis showed that high risk according to the Mantle Cell Lymphoma International Prognostic Index (MIPI) and nonresponse to ibrutinib at the first three cycles were significantly associated with inferior OS. Poor PFS was associated with high‐risk biologic MIPI, prior bendamustine exposure, and nonresponse to ibrutinib during the first three cycles. After ibrutinib failure, primary nonresponders had poorer OS and PFS than inconsistent responders. The overall response rate for the first salvage therapy was only 33%, with a median TTP of 3.2 months. There was no effective therapeutic strategy except for allogeneic hematopoietic stem cell transplantation (allo‐HSCT). Although ibrutinib responders exhibited favorable survival outcomes, nonresponders had a dismal prognosis. To overcome these limitations, it may be necessary to modify therapeutic strategies, such as selecting inconsistent responders for earlier allo‐HSCT.
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spelling pubmed-68538112019-12-16 Clinical outcomes for ibrutinib in relapsed or refractory mantle cell lymphoma in real‐world experience Jeon, Young‐Woo Yoon, Seugyun Min, Gi June Park, Sung‐Soo Park, Silvia Yoon, Jae‐Ho Lee, Sung‐Eun Cho, Byung‐Sik Eom, Ki‐Seong Kim, Yoo‐Jin Kim, Hee‐Je Lee, Seok Min, Chang‐Ki Lee, Jong Wook Cho, Seok‐Goo Cancer Med Clinical Cancer Research Ibrutinib is highly effective in patients with relapsed or refractory mantle cell lymphoma (MCL) in major clinical trials. Although there has been a dramatic improvement in survival outcomes in the salvage setting, nonresponders to ibrutinib have a bleak prognosis. Therefore, this retrospective study was conducted to identify the most appropriate therapeutic strategy and prognosis‐related factors to predict the response of patients with relapsed or refractory MCL to ibrutinib monotherapy. Thirty‐three consecutive refractory or relapsed MCL patients treated with ibrutinib were analyzed in this study. The median overall survival (OS) and progression‐free survival (PFS) after initiation of ibrutinib were 35.1 months and 27.4 months, respectively. Risk factor analysis showed that high risk according to the Mantle Cell Lymphoma International Prognostic Index (MIPI) and nonresponse to ibrutinib at the first three cycles were significantly associated with inferior OS. Poor PFS was associated with high‐risk biologic MIPI, prior bendamustine exposure, and nonresponse to ibrutinib during the first three cycles. After ibrutinib failure, primary nonresponders had poorer OS and PFS than inconsistent responders. The overall response rate for the first salvage therapy was only 33%, with a median TTP of 3.2 months. There was no effective therapeutic strategy except for allogeneic hematopoietic stem cell transplantation (allo‐HSCT). Although ibrutinib responders exhibited favorable survival outcomes, nonresponders had a dismal prognosis. To overcome these limitations, it may be necessary to modify therapeutic strategies, such as selecting inconsistent responders for earlier allo‐HSCT. John Wiley and Sons Inc. 2019-09-27 /pmc/articles/PMC6853811/ /pubmed/31560165 http://dx.doi.org/10.1002/cam4.2565 Text en © 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Cancer Research
Jeon, Young‐Woo
Yoon, Seugyun
Min, Gi June
Park, Sung‐Soo
Park, Silvia
Yoon, Jae‐Ho
Lee, Sung‐Eun
Cho, Byung‐Sik
Eom, Ki‐Seong
Kim, Yoo‐Jin
Kim, Hee‐Je
Lee, Seok
Min, Chang‐Ki
Lee, Jong Wook
Cho, Seok‐Goo
Clinical outcomes for ibrutinib in relapsed or refractory mantle cell lymphoma in real‐world experience
title Clinical outcomes for ibrutinib in relapsed or refractory mantle cell lymphoma in real‐world experience
title_full Clinical outcomes for ibrutinib in relapsed or refractory mantle cell lymphoma in real‐world experience
title_fullStr Clinical outcomes for ibrutinib in relapsed or refractory mantle cell lymphoma in real‐world experience
title_full_unstemmed Clinical outcomes for ibrutinib in relapsed or refractory mantle cell lymphoma in real‐world experience
title_short Clinical outcomes for ibrutinib in relapsed or refractory mantle cell lymphoma in real‐world experience
title_sort clinical outcomes for ibrutinib in relapsed or refractory mantle cell lymphoma in real‐world experience
topic Clinical Cancer Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6853811/
https://www.ncbi.nlm.nih.gov/pubmed/31560165
http://dx.doi.org/10.1002/cam4.2565
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