Professor Wang Luhua: Ibrutinib combined regimen brings long-term significant survival benefits for newly treated MCL patients

Mantle cell lymphoma (MCL) is a B-cell malignant tumor with high aggressiveness and poor prognosis.
Traditional chemotherapy has limited efficacy and some patients cannot tolerate it, which cannot meet the treatment needs of the majority of patients.

In recent years, domestic and foreign scholars have begun to continuously explore more effective and safe programs, especially the combination program based on Ibrutinib has brought new hope for the treatment of MCL.

On April 18, 2021, the First National Lymphocytic Disease Academic Conference of the Chinese Medical Association and the 2021 International Lymphoma Update Symposium opened in Chengdu, Sichuan Province, the land of abundance.
Professor Wang Luhua from MD Anderson Cancer Center, USA, shared Ibrutinib with you The combined program has shown remarkable efficacy and good safety in different populations of first-line treatment of MCL, which has brought new inspiration to the clinical treatment of MCL in my country.

IR sequential R-HCVAD treatment of young (<65 years old) newly-treated MCL patients, the 5-year PFS rate reached 66%, Professor Luhua Wang introduced that the WINDOW-1 study included a total of 131 young newly-treated MCL patients (median age of 56).
Years old), received IR regimen (Ibrutinib+Rituximab) induction therapy and sequential R-HCVAD regimen consolidation therapy, with a median follow-up of 40 months.

Studies have shown that under the induction of the IR regimen, the overall response rate (ORR) of newly treated MCL patients can reach 88%, and the ORR of low-risk patients can reach as high as 90%.

In the entire treatment process, the negative rate of minimal residual disease (MRD) can reach 74%.

In the long-term follow-up of this study, the 5-year progression-free survival (PFS) rate of patients was 66%.
Among patients with ki-67<30, the 5-year PFS rate was as high as 81%.

Compared with traditional chemotherapy regimens, the incidence of adverse events during the treatment of IR regimen is lower, and most of them are grade 1-2, showing that the combination regimen of ibrutinib has good safety.

In the treatment of elderly patients (>65 years old) with newly treated MCL with IR regimen, the 5-year PFS rate is as high as 88%.
Professor Wang Luhua said that the IR regimen has shown a more excellent therapeutic effect for elderly patients with newly treated MCL.

A phase II study included 50 elderly (>65 years) newly-treated MCL patients with a median follow-up of 43 months.

Studies have shown that after treatment with IR without chemotherapy, the ORR of patients with early-treated MCL can reach 90%, the complete remission (CR) rate is as high as 62%, and the MRD negative rate is close to 90% (87%).

Long-term follow-up data show that the first-line treatment of the IR program has excellent survival benefits.
After 50 elderly MCL patients were treated for 5 years, only 4 patients had disease progression, and the 5-year PFS rate was as high as 88%.

For elderly patients, the IR program also showed good safety.

During the median follow-up of 43 months, most of the adverse reactions were grade 1-2 and were relatively mild.

Professor Luhua Wang said: "Through the long-term data of these two large international studies, the combined application of Ibrutinib is a very effective chemotherapy-free treatment for young or old newly-treated MCL patients.
In the
future, I hope that scientific researchers in the field of blood in China can continue to carry out more clinical studies and real-world studies related to ibrutinib, further explore the efficacy and safety of ibrutinib and its combination in the first-line treatment of MCL, and improve our country The survival benefits and quality of life of MCL patients have allowed them to regain their good hope.

"References: 1.
ASH 2020.
Abstract #20372.
ASH 2020.
Abstract #2042 stamp "Read the original text", we make progress together