R/R MCL: new combo regimen shows promise in salvage patients

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Takeaway

  • Bortezomib (Velcade) + cyclophosphamide  (Cytoxan) + rituximab (Rituxan, BCR) is a new, efficacious, and well-tolerated salvage regimen for the treatment relapsed/refractory mantle cell lymphoma (R/R MCL).

Why this matters

  • Relapsed/refractory (R/R) MCL has poor prognosis and is associated with multiple genetic drivers necessitating therapeutic targeting of multiple pathways.

Study design

  • Phase 2 study to investigate the safety and efficacy of combination BCR in 21 patients with R/R MCL; median age: 66 y.
  • Funding: Millennium: The Takeda Oncology Company.

Key results

  • Median of 3 cycles received in 19 patients; among these, 74% achieved response and 42% achieved complete response.
  • 9 mo median PFS.
  • 36.4 mo median OS.
  • Grade 3-4 nonhematologic AEs occurred in 1% of cycles; 25% of cycles resulted in grade 3-4 neutropenia, or thrombocytopenia.
  • 6 grade 1 cases of sensory neuropathy and 1 grade 2 case.

Limitations

  • Limited sample size.
  • Single-arm study.
  • Lack of neuropathy may be explained by low number of treatment cycles.