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Outcomes After BTK Inhibition in Mantle Cell Lymphoma: View From the United States and Japan

By: Julia Fiederlein
Posted: Friday, August 19, 2022

Shinya Rai, MD, PhD, of the Kindai University Faculty of Medicine, Osakasayama, Japan, and colleagues conducted a study to investigate the real-world treatment patterns and outcomes of two cohorts of patients with mantle cell lymphoma who were previously treated with a covalent Bruton’s tyrosine kinase (BTK) inhibitor. The results, which were presented during the European Hematology Association (EHA) 2022 Congress (Abstract P1134), highlight the need for new effective subsequent therapies in this setting.

“Patients with mantle cell lymphoma previously treated with covalent BTK inhibition experience very poor outcomes, as measured by their duration of subsequent therapy and overall survival,” the investigators commented. “Data were generally consistent between the United States and Japan.”

Using the ConcertAI and Medical Data Vision databases, the investigators identified patients from the United States (n = 946) and Japan (n = 196) who completed treatment with at least one covalent BTK inhibitor between their first and third lines of therapy. A total of 37.2% of the U.S. cohort and 52.6% of the Japan cohort received subsequent . In the U.S. cohort, immediate subsequent regimens included rituximab (with or without other chemotherapy agents; 43.2%) or additional covalent BTK inhibitor–based (41.5%) or BCL2 inhibitor–based (8.5%) therapy. According to the investigators, in the Japan cohort, the immediate subsequent regimens were nearly exclusively chemotherapy-based (89.3%); a total of 10.7% of patients were retreated with covalent BTK inhibitor–containing regimens.

The median durations of time from the end of covalent BTK inhibition to the discontinuation of immediate subsequent therapy or death were 3.9 and 2.4 months, respectively, in the U.S. and Japan cohorts. The duration of subsequent therapy was longer in the U.S. cohort than in the Japan cohort (2.6 vs. 1.8 months). The median duration of overall survival from the discontinuation of covalent BTK inhibition was 10.3 months in the U.S. cohort and 7.1 months in the Japan cohort.

Disclosure: For full disclosures of the study authors, visit

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