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Changes in Frontline Therapy Associated With Improved Survival Outcomes Among Patients With MCL
Study findings provide real-world evidence for improved outcomes with the evolving frontline pattern of care in patients with mantle cell lymphoma (MCL; Blood Adv. 2021. doi:10.1182/bloodadvances.2021005715).
“With the advances in MCL frontline treatment over the last two decades we sought to characterize the frontline treatment pattern change and its association with outcomes,” wrote Alessia Castellino, MD, Santa Croce e Carle Hospital, Italy, and colleagues.
This prospective cohort study included patients newly diagnosed with MCL between September 2002 and June 2015. Participants were divided into 2 groups: those diagnosed in 2002-2009 (Era 1), and those diagnosed in 2010-2015 (Era 2). Clinical characteristics, treatment, and clinical outcomes were compared between groups.
Age, sex, and simplified MIPI score were similar between patients in Era 1 and Era 2. Less use of R-Hyper-CVAD was observed among patients who were age 65 or younger (16.1% vs 8.8%), but more Nordic and R-CHOP/R-DHAP regimens (1.1% vs 26.4%), and less use of R-CHOP/R-CHOP-like regimen (64.5% vs 35.2%) but more R-Bendamustine (0% vs 12.1%) in Era 2 (P <.001).
These changes in treatment were associated with improved event free survival (EFS) and overall survival (OS) in Era 2. The 5-year EFS was 34.3% in Era 1 vs 50% in Era 2 (P = .010) and 5-year OS was 68.8% vs 81.6%, respectively (P = .017).
Less use of R-CHOP/R-CHOP-like (39% vs 14.3%) and non-standard systemic therapy (36.6% vs 13%), but more R-Bendamustine (0% vs 49.4%) was observed among patients who were older than 65 years of age. This use was associated with improved EFS (5-year 25.4% vs 37.5%, P = .051) in Era 2. In additiona, the trend toward R-CHOP/R-CHOP-like regimen to R-Bendamustine was associated with improved EFS (5-year 25% vs 44.6%, P = .008) in Era 2.
“Results from this prospective cohort study provide critical real-world evidence for improved outcomes with evolving frontline pattern of care in patients with MCL,” Dr Alessia and colleagues concluded.
