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Real-World Treatment Patterns Among Patients With Mantle Cell Lymphoma
A recent study found that bendamustine and rituximab was the most used frontline regimen for the treatment of mantle cell lymphoma (MCL), while Bruton Tyrosine Kinase (BTK) inhibitors were the most used agents in later lines of therapy (Blood Adv. 2022; bloodadvances.2022007247. doi:10.1182/bloodadvances.2022007247).
Use of targeted therapies such as BTK inhibitors has increased among elderly patients who are being treated for MCL, due to ineffectiveness of the available chemoimmunotherapy approaches.
In this study, Mayur Narkhede, MD, University of Alabama at Birmingham, Birmingham, Alabama, and colleagues “aimed to describe the treatment patterns in MCL at different lines of therapy with a focus on BTK inhibitor use and compare outcomes with known prognostic factors using a nationwide Flatiron Health electronic health record (EHR)-derived de-identified database.
Patient data from the years 2011 to 2021 lead Dr Narkhede and team to find that among the 4336 patients with MCL who were included in this study, 42% received bendamustine plus rituximab chemotherapy, making it the most commonly used frontline regimen. Among all patients, 31% received Maintenance rituximab or consolidative autologous stem cell transplant (ASCT), with only 34% of those receiving ASCT as consolidation therapy subsequently receiving rituximab maintenance.
In second or later lines of therapy, 933 participants (57%) received BTK inhibitors, the most preferred agents.
“Among patients treated with BTK inhibitors, the median real-world overall survival was 35 months (95% CI 27-50), 24 months (95% CI 22 - 30), and 18 months (95% CI 14 - 21), for first line, second line and for third or later line of therapy, respectively,” wrote the authors.
“Patients with deletion 17p/TP53 mutation and blastoid variant MCL had poor outcomes,” concluded Dr Narkhede and colleagues, adding, “however, BTK inhibitors appeared to mitigate the negative influence of del17p/TP53 mutated MCL with an HR of 1.17 (95% CI 0.88 - 1.55) on multivariable analysis.”
