A new study assessed clinical outcomes and predictors of survival in older patients with mantle cell lymphoma (MCL) treated in the rituximab era.
Results of the study are to be presented at the American Society of Clinical Oncology (ASCO) Annual Meeting (May 28-30, 2020).
Reem Karmali, MD, MS, assistant professor of medicine, Northwestern University Feinberg School of Medicine, and colleagues sought to evaluate clinical outcomes and predictors of survival in older patients with MCL. Researchers included data from 12 cancer centers for 1168 patients aged at least 65 years with newly diagnosed MCL treated between 2000 and 2015.
The primary objective of the study was to characterize practice patterns and survival outcomes in older patients. Researchers also sought to assess predictive factors of survival. For 465 patients aged at least 65 years, variable denominators indicated missing data: sixty-nine percent (n = 305 of 444) of patients were male; and 8% (n = 23), 39% (n = 110), and 53% (n = 148) of 281 patients had low-, intermediate-, and high-risk MCL International Prognostic Index, respectively.
Among the 407 older patients with available initial treatment data, 36% (n = 148) received bendamustine plus rituximab, 16% (n = 65) received a cytarabine-containing regimen, 2% (n = 9) received lenalidomide, and 23% (n = 92) received other treatments that excluded BTK inhibitors. Additionally, researchers noted that 19% (n = 68 of 365) of patients were enrolled in a clinical trial for initial therapy, 24% (n = 88 of 369) of patients received autologous transplant during first remission, and 44% (n = 155 of 351) of patients received maintenance rituximab.
Dr Karmali and colleagues compared progression-free survival (PFS) and overall survival (OS) across older age cohorts: less than 65 years, 65-69 years, and at least 70 years. Two-year PFS rates were 79%, 69%, and 66%, respectively. Additionally, 2-year OS rates were 92%, 87%, and 84%, respectively (P < .001).
Furthermore, researchers found that autologous transplant during first remission did not significantly impact PFS or OS.
“In this large cohort of older patients in the rituximab era, survival outcomes remain inferior to younger patients,” authors of the study concluded. “As such, our data does not reliably reflect the potential advancements in survival achieved with the introduction of BTK inhibitors.”
They added that focused clinical trials will be necessary to identify effective therapeutics in the older population.—Zachary Bessette
