Survival in Mantle Cell Lymphoma Improves With Shifts in Treatment Patterns
A real-world study using SEER-Medicare data found significant improvements in survival outcomes for older patients with mantle cell lymphoma (MCL), coinciding with an increased use of rituximab-bendamustine (BR) and Bruton tyrosine kinase inhibitors (BTKis).
The study analyzed 5441 patients aged >65 years diagnosed with MCL between 2002 and 2019. Of these, 4382 received first-line therapy and 1538 received second-line therapy. Outcomes assessed included overall survival from first-line therapy (OS1), overall survival from second-line therapy (OS2), and time to next therapy (TTNT).
BR use in the first-line setting rose sharply—from under 2% of patients diagnosed between 2002 and 2005 to 54% among those diagnosed between 2014 and 2019. BTKi-based regimens, approved for second-line use in 2013, made up 8% of first-line and 54% of second-line therapies in patients diagnosed during the 2014–2019 period.
OS1 improved significantly across diagnosis year categories (P < .0001), suggesting that access to newer therapies has contributed to better survival. “We observed improvements in both OS1 and TTNT over time, which may correlate with increased BR and BTKi use as first-line agents,” the authors wrote.
TTNT also lengthened over the study period, indicating delayed need for subsequent treatment. However, gains in OS2 were less pronounced.
“Unexpectedly, OS2 improvements were more modest,” the study noted, highlighting the limited progress in outcomes after second-line treatment.
These results suggest that newer agents have meaningfully improved early treatment outcomes in MCL but also emphasize the need for continued innovation in therapies for relapsed disease. The findings support the importance of optimizing first-line strategies and reinforce the urgency for advancing second-line options.
Reference
Luan D, Easwar N, Chen Z, et al. Improvements in outcomes in older patients with mantle cell lymphoma are associated with improvements across multiple lines of therapy. Clin Lymphoma Myeloma Leuk. Published online ahead of print January 2025. doi:10.1016/j.clml.2025.01.008
