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<p>Addition of Bruton’s tyrosine kinase inhibitor (BTKi) to first-line (1 L) bendamustine-rituximab (BR) improved progression-free survival (PFS) in patients with mantle cell lymphoma (MCL) in the SHINE and ECHO trials. We investigated whether sequential treatment with 1 L BR and second-line (2 L) BTKi can result in similar cumulative PFS compared to BR-BTKi combination therapy, using a multicenter cohort of 755 patients treated with 1 L BR between 2014 and 2020. Event-free survival (EFS), EFS2, and overall survival (OS) were analyzed. By intention-to-treat (ITT), EFS2 was defined as time from 1 L BR start to progression/relapse or retreatment following 2 L BTKi or death. After a median follow-up of 61.4 (95% CI 56.4–65.9) months, the median EFS after 1 L BR was 34.2 (95% CI 31.5–38.4) months. The median EFS2 following 1 L BR and 2 L BTKi by ITT analysis was 64.8 (95% CI 56.7–82.8) months, and the 5-year OS rate after 1 L BR was 57.9% (95% CI 54.1–62.0%), close to SHINE and ECHO results. Patients without high-risk features (high simplified MIPI, high Ki-67, blastoid/pleomorphic morphology, <i>TP53</i> mutation, or complex karyotype) had more favorable survival outcomes. These results suggest that sequential treatment with 1 L BR and 2 L BTKi remains reasonable for select patients with MCL, particularly those without high-risk features.</p>

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Mantle cell lymphoma outcomes following sequential first-line bendamustine-rituximab and second-line Bruton’s tyrosine kinase inhibitor therapy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月25日

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  • Yucai Wang,
  • Melissa C. Larson,
  • Steven R. Hwang,
  • Diego Villa,
  • Laveniya Kugathasan,
  • Anita Kumar,
  • Ashlee Joseph,
  • Taylor R. Brooks,
  • Brian T. Hill,
  • David A. Bond,
  • Kami J. Maddocks,
  • Alexey Danilov,
  • Christine Argao,
  • Jia Ruan,
  • Imran A. Nizamuddin,
  • Brad S. Kahl,
  • Natalie S. Grover,
  • Nazneen B. Khan,
  • Georgios N. Pongas,
  • Izidore S. Lossos,
  • Evguenia Ouchveridze,
  • Aung M. Tun,
  • Firas Baidoun,
  • Muhamad Alhaj Moustafa,
  • Zoey I. Harris,
  • Javier L. Munoz,
  • Philip R. Young,
  • Craig A. Portell,
  • Patrick M. Reagan,
  • Christine E. Ryan,
  • Reid W. Merryman,
  • Arash Velayati,
  • I. Brian Greenwell,
  • Drew G. Gerber,
  • Preetesh Jain,
  • Michael L. Wang,
  • Sabarish R. Ayyappan,
  • Eric Mou,
  • Lauren G. Banaszak,
  • Priyanka A. Pophali,
  • Anthony C. Stack,
  • Marcus R. Messmer,
  • Mayur S. Narkhede,
  • Amitkumar Mehta,
  • Tamara K. Moyo,
  • Nilanjan Ghosh,
  • Rahul S. Bhansali,
  • Stefan K. Barta,
  • Manali K. Kamdar,
  • Jacob Anna,
  • Alexander V. Stanisic,
  • Reem Karmali,
  • Matthew J. Maurer,
  • James R. Cerhan,
  • Jonathon B. Cohen,
  • Peter Martin

摘要

Addition of Bruton’s tyrosine kinase inhibitor (BTKi) to first-line (1 L) bendamustine-rituximab (BR) improved progression-free survival (PFS) in patients with mantle cell lymphoma (MCL) in the SHINE and ECHO trials. We investigated whether sequential treatment with 1 L BR and second-line (2 L) BTKi can result in similar cumulative PFS compared to BR-BTKi combination therapy, using a multicenter cohort of 755 patients treated with 1 L BR between 2014 and 2020. Event-free survival (EFS), EFS2, and overall survival (OS) were analyzed. By intention-to-treat (ITT), EFS2 was defined as time from 1 L BR start to progression/relapse or retreatment following 2 L BTKi or death. After a median follow-up of 61.4 (95% CI 56.4–65.9) months, the median EFS after 1 L BR was 34.2 (95% CI 31.5–38.4) months. The median EFS2 following 1 L BR and 2 L BTKi by ITT analysis was 64.8 (95% CI 56.7–82.8) months, and the 5-year OS rate after 1 L BR was 57.9% (95% CI 54.1–62.0%), close to SHINE and ECHO results. Patients without high-risk features (high simplified MIPI, high Ki-67, blastoid/pleomorphic morphology, TP53 mutation, or complex karyotype) had more favorable survival outcomes. These results suggest that sequential treatment with 1 L BR and 2 L BTKi remains reasonable for select patients with MCL, particularly those without high-risk features.