Evaluating Chemo-Free Novel Agent Combination Therapies for Mantle Cell Lymphoma

At the 2023 Lymphoma, Leukemia & Myeloma Congress in New York, New York, Jia Ruan, MD, PhD, Weill Cornell Medicine, New York, New York, discusses the introduction of novel agents in a chemotherapy-free format for the treatment of patients with mantle cell lymphoma (MCL).

Transcript:

Hi, my name is Dr Jia Ruan. I'm a lymphoma [clinician] attending at Weill Cornell New York Hospital. I take care of patients with a number of different types of lymphomas, and I'm actually here attending the Lymphoma, Leukemia [& Myeloma] Conference in New York City. 

I think we're very excited about try[ing] to introduce the novel agents and their combination in a chemotherapy-free format. There are some examples of those studies, which include one of the trials that we conducted that has a very long-term follow-up. I think the median follow-up is 9 years now, with a combination of rituximab and lenalidomide, which is an immune-modulatory compound. We provided the combination—the R2 combination—to patients with untreated mantle cell lymphoma, and it has achieved very high efficacy and a very durable remission. Up to 60% of patients remain lymphoma-free after 7 years, and over 50% remain to be lymphoma-free after 9 years.

That is the first study in [a] chemo-free regimen. There [are] 2 others with fairly long follow-ups with [Bruton’s tyrosine kinase] (BTK) inhibitor ibrutinib plus rituximab. We're very excited to find out with more studies, using chemo-free combinations, and what the long-term effectiveness and safety profile [is], and eventually try to understand how they compare head-to-head with chemoimmunotherapy.

There [are] 2 studies currently ongoing, and we look forward to the outcome[s]. One of them is the ENRICH study, which compares ibrutinib-rituximab induction and ibrutinib-rituximab maintenance, versus chemoimmunotherapy. The second one is the MANGROVE study, which is looking at zanubrutinib plus rituximab, and comparing [it] with bendamustine-rituximab-based chemoimmunotherapy.

In conclusion, I'm very excited, and it has been a very gratifying learning experience. I think we're fortunate to be in an era where there [are] a lot of new agents that are convenient and safe, and have very high activity. We look forward to mov[ing] those agents into earlier, including the frontline setting, for patients with mantle cell lymphoma.

Source: 

Ruan J. Initial Therapy for Mantle Cell Lymphoma. Presented at Lymphoma, Leukemia & Myeloma Congress; October 18-21, 2023. New York, NY