Predictive factors and outcomes for ibrutinib therapy in relapsed/refractory mantle cell lymphoma—a “real world” study
- 8 January 2017
- journal article
- research article
- Published by Wiley in Hematological Oncology
- Vol. 35 (4), 528-535
- https://doi.org/10.1002/hon.2380
Abstract
Ibrutinib has demonstrated significant activity in relapsed/refractory mantle cell lymphoma (MCL) in clinical trials. However, the impact of hematopoietic cell transplantation on the outcomes of ibrutinib and the predictive factors for ibrutinib response has not been well studied. Hence, we conducted a multicenter retrospective study of MCL patients who received ibrutinib to (1) determine the overall response rate (ORR), duration of response (DOR), progression‐free survival (PFS), and overall survival (OS) of ibrutinib in routine clinical practice, (2) examine characteristics predictive of response to ibrutinib therapy, and (3) describe the outcomes of patients failing ibrutinib. Ninety‐seven patients met the eligibility criteria. Overall response rate and median DOR to ibrutinib were 65% and 17 months, respectively. Only lack of primary refractory disease was predictive of ibrutinib response on multivariate analysis. Twenty‐nine patients received postibrutinib therapies, with an ORR of 48% and a median DOR of 3 months. The median OS and PFS for the entire group (n = 97) was 22 and 15 months, respectively. On multivariate analysis, ibrutinib response, low MCL international prognostic index, and absence of primary refractory disease were predictors of better PFS, while ibrutinib response and Eastern Cooperative Oncology Group performance status ≤1 were predictors of better OS. The median OS postibrutinib failure was 2.5 months. Our results confirm the high ORR and DOR of ibrutinib in MCL and that prior hematopoietic cell transplantation does not negatively influence ibrutinib outcomes. Survival following ibrutinib failure is poor with no specific subsequent therapy showing superior activity in this setting. As a result, for select (transplant eligible) patients, allogeneic transplant should be strongly considered soon after ibrutinib response is documented to provide durable responses.Keywords
This publication has 20 references indexed in Scilit:
- Ibrutinib versus temsirolimus in patients with relapsed or refractory mantle-cell lymphoma: an international, randomised, open-label, phase 3 studyThe Lancet, 2015
- Long-term follow-up of MCL patients treated with single-agent ibrutinib: updated safety and efficacy resultsPublished by American Society of Hematology ,2015
- Bruton tyrosine kinase is commonly overexpressed in mantle cell lymphoma and its attenuation by Ibrutinib induces apoptosisLeukemia Research, 2013
- Targeting BTK with Ibrutinib in Relapsed or Refractory Mantle-Cell LymphomaNew England Journal of Medicine, 2013
- Is hematopoietic cell transplantation still a valid option for mantle cell lymphoma in first remission in the chemoimmunotherapy-era?Bone Marrow Transplantation, 2013
- Mantle cell lymphomaCritical Reviews in Oncology/Hematology, 2012
- Improvement of Overall Survival in Advanced Stage Mantle Cell LymphomaJournal of Clinical Oncology, 2009
- Incidence trends of mantle cell lymphoma in the United States between 1992 and 2004Cancer, 2008
- From centrocytic to mantle cell lymphoma: A clinicopathologic and molecular review of 3 decadesHuman Pathology, 2002
- A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group [see comments]Blood, 1994