In:
Blood Advances, American Society of Hematology
Abstract:
Maintenance rituximab in MCL has improved survival and supports exploration of maintenance with novel agents. We evaluated the safety and efficacy of Ibrutinib maintenance (I-M) following induction in patients with treatment-naive MCL. Patients with MCL with CR/PR to frontline chemo-immunotherapy +/- autologous stem cell transplantation (autoSCT) received I-M 560 mg daily for up to 4 years. Primary objective was 3-year PFS rate from initiation of I-M. Minimal residual disease (MRD) assessments by NGS on peripheral blood were measured prior to I-M initiation and at 1, 6 and 18-24 mo(s) post initiation. Among 36 patients, median age was 60 (range 46-90). For frontline treatment, 18 (50%) had consolidation with autoSCT in CR1 prior to I-M. At median follow-up of 55.7 months, 17 (47 %) patients completed full course I-M (median 37.5 cycles, range 2-52). The 3-year PFS and OS rates were 94% and 97% respectively. With prior autoSCT, 3-year PFS and OS rates were both 100%. The most common treatment related adverse event (TRAE) with I-M was infection (n=31, 86%), typically low grade; the most common grade 3/4 toxicities were hematologic. In 22 patients with MRD assessments, all were MRD (-) after induction. Six became MRD (+) on I-M with 2 reverting to MRD (-) status with continued I-M and all maintain radiographic CR with the exception of 1 with disease progression. I-M is feasible in MCL after frontline chemo-immunotherapy with manageable toxicities though significant. Changes in NGS-MRD were noted in limited patients during maintenance with few progression and survival events.
Type of Medium:
Online Resource
ISSN:
2473-9529
,
2473-9537
DOI:
10.1182/bloodadvances.2023011271
Language:
English
Publisher:
American Society of Hematology
Publication Date:
2023
detail.hit.zdb_id:
2876449-3
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