Seven-year outcomes of venetoclax-ibrutinib therapy in mantle cell lymphoma: durable responses and treatment-free remissions

伊布替尼 威尼斯人 医学 套细胞淋巴瘤 内科学 肿瘤科 淋巴瘤 白血病 慢性淋巴细胞白血病
作者
Sasanka M. Handunnetti,Mary Ann Anderson,Kate Burbury,Philip A. Thompson,Glenda Burke,Mathias Bressel,Juliana L Di Iulio,Rodney J. Hicks,David Westerman,Stephen Lade,Christiane Pott,Rishu Agarwal,Rachel Koldej,David Ritchie,Martin Dreyling,Mark A. Dawson,Sarah‐Jane Dawson,John F. Seymour,Andrew W. Roberts,Constantine S. Tam
出处
期刊:Blood [Elsevier BV]
卷期号:144 (8): 867-872 被引量:12
标识
DOI:10.1182/blood.2023023388
摘要

In the phase 2 clinical trial (AIM) of venetoclax-ibrutinib, 24 patients with mantle cell lymphoma (MCL; 23 with relapsed/refractory [R/R] disease) received ibrutinib 560 mg and venetoclax 400 mg both once daily. High complete remission (CR) and measurable residual disease negative (MRD-negative) CR rates were previously reported. With median survivor follow-up now exceeding 7 years, we report long-term results. Treatment was initially continuous, with elective treatment interruption (ETI) allowed after protocol amendment for patients in MRD-negative CR. For R/R MCL, the estimated 7-year progression-free survival (PFS) was 30% (95% confidence interval [CI], 14-49; median, 28 months; 95% CI, 13-82) and overall survival (OS) was 43% (95% CI, 23-62; median, 32 months; 95% CI, 15 to not evaluable). Eight patients in MRD-negative CR entered ETI for a median of 58 months (95% CI, 37-79), with 4 experiencing disease recurrence. Two of 3 reattained CR on retreatment. Time-to-treatment failure (TTF), which excluded progression in ETI for those reattaining response, was 39% overall and 68% at 7 years for responders. Beyond 56 weeks, grade ≥3 and serious adverse events were uncommon. Newly emergent or increasing cardiovascular toxicity were not observed beyond 56 weeks. We demonstrate long-term durable responses and acceptable toxicity profile of venetoclax-ibrutinib in R/R MCL and show feasibility of treatment interruption while maintaining ongoing disease control. This trial was registered at www.clinicaltrials.gov as #NCT02471391.
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