MCL: consolidation radioimmunotherapy extends survival in unfit patients

  • Jurczak W & al.
  • Leuk Lymphoma
  • 9 Apr 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • In patients with mantle cell lymphoma (MCL) ineligible/unwilling to undergo high-dose chemotherapy autologous stem cell transplant (ASCT), radioimmunotherapy (RIT) with 90Y ibritumomab tiuxetan (90Y) markedly improved survival outcomes.

Why this matters

  • Prognosis is poor in MCL, with survival rarely exceeding 5 years.

Study design

  • 8-year follow-up of a phase 2 study to investigate consolidation 90Y in 46 patients with MCL chemosensitive to first-line (1L) or second-line (2L) therapy who were high-dose chemotherapy ASCT ineligible/unwilling.
  • 34 patients received 90Y consolidation after 1L therapy; 12 after 2L therapy.
  • Median patient age, 60 (range, 30-78) years. 
  • Funding: Schering AG.

Key results

  • In patients with 1L induction, 90Y consolidation increased complete response (CR) rate from 41% to 91%.
  • In patients with 2L induction, 90Y consolidation increased CR from 16% to 75%.
  • Survival outcomes with 1L vs 2L induction, respectively:
    • Median PFS: 3.3 years vs 1.8 years (P<.05>
    • Median OS: 6.5 years vs 2.2 years (P<.05>
  • Median PFS 5.8 years in patients who achieved CR after 1L therapy vs 2.8 years in those who achieved partial response.
  • No new safety signals were observed with 90Y.

Limitations

  • Limited sample size.

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