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Leo I. Gordon, MD, FACP


Older Patients With Mantle Cell Lymphoma: Phase II Trial Focuses on Ibrutinib Plus Rituximab

By: Joshua D. Madera, MS
Posted: Tuesday, February 1, 2022

For elderly patients with mantle cell lymphoma, the chemotherapy-free combination of ibrutinib and rituximab was shown to be an effective therapeutic option, according to a phase II clinical trial published in the Journal of Clinical Oncology. However, prior to implementation of this therapeutic regimen, “baseline evaluation for cardiovascular risks is highly recommended,” commented Michael L. Wang, MD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues. However, the authors cautioned, a randomized trial to confirm their findings is necessary.

A total of 50 patients with mantle cell lymphoma were recruited for the study. Those with blastoid morphology or Ki67 expression levels greater than or equal to 50% were excluded. All patients received ibrutinib and rituximab for a maximum of 2 years followed by ibrutinib therapy alone.

The study authors reported that 76% of patients had a Ki67 index below 30%, and 24% had a Ki67 index between 30% and 50%. In addition, they found a 96% overall response rate. The authors reported that 56% of patients discontinued treatment at a median follow-up of 45 months due to toxicity (n = 21), disease progression (n = 4), and miscellaneous reasons (n = 3). Several adverse effects were reported in patients, including grade 3 atrial fibrillation (22%) and grade 3 or 4 myelosuppression (< 5%). Moreover, genetic overexpression of BANK1, AXIN2, CCND1, IL2RA, BIRC3, and SETBP1 was identified in patients classified as partial responders as compared with those who were complete responders.

Disclosure: For full disclosures of the study authors, visit

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