Site Editor
Jeremy S. Abramson, MD, MMSc
Jeremy S. Abramson, MD, MMSc
Posted: Monday, January 27, 2025
Efforts to identify an effective treatment strategy for elderly patients with mantle cell lymphoma have recommended a response-adapted treatment strategy, which may lead to improved clinical outcomes in this patient population, according to a presentation given at the 2024 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 747). The findings from the ALTAMIRA phase II clinical trial suggest the combination of the Bruton’s tyrosine kinase inhibitor acalabrutinib and the monoclonal antibody rituximab may become the new standard of care for managing mantle cell lymphoma, explained Mats Jerkeman, MD, PhD, of Skane University Hospital and Lund University, Sweden, and colleagues.
A total of 81 patients with untreated mantle cell lymphoma were recruited for the study. All patients were required to be at least 60 years old and were ineligible for transplantation. Patients were treated with combination therapy of acalabrutinib and rituximab. Those who achieved complete remission or molecular remission in the bone marrow and blood stopped acalabrutinib therapy after the completion of 13 months of treatment but continued on rituximab. Patients with mutations in TP53 or evidence of blastoid histology were continued on treatment until they demonstrated evidence of disease progression or experienced intolerable treatment-related adverse events. In addition, patient data were matched and compared with data from the population-based Swedish MCLcomplete project.
The study authors reported a 95% objective response rate at the 6-month interval. Patients in the current study had improved progression-free survival (86.5%) and overall survival (92.9%) rates compared with patients from the MCLcomplete project (71.8% and 79.6%, respectively). However, the progression-free survival rate was decreased in patients with TP53 mutations (69.0%). Furthermore, at the 12-month interval, 59% of patients had measurable residual disease–negative disease. Moreover, the most common treatment-related adverse events included neutropenia, infection, and cardiovascular toxicity.
Disclosure: For full disclosures of the study authors, visit ash.confex.com.
2024 ASH Annual Meeting & Exposition
