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Jeremy S. Abramson, MD, MMSc
Jeremy S. Abramson, MD, MMSc
Posted: Tuesday, February 25, 2025
Treatment with the Bruton’s tyrosine kinase inhibitor acalabrutinib, lenalidomide, and rituximab (ALR) may lead to improved clinical response rates in patients with mantle cell lymphoma (MCL), according to a study presented at the 2024 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 746). This therapeutic approach is a feasible, time-limited initial management approach in this patient population, suggested Jia Ruan, MD, PhD, of Weill Cornell Medicine, New York, and colleagues.
A total of 34 patients with TP53 wild-type and mutant MCL were recruited for the study. All patients had either stage III or IV disease. Patients received combination treatment with acalabrutinib, lenalidomide, and either rituximab (n = 24) or the monoclonal antibody obinutuzumab (ALO, n = 10).
The study findings revealed that after 12 cycles of induction therapy, the overall response and complete response rates were 100% and 83%, respectively, in patients treated with ALR therapy. Rates of 95.2% and 87.5% overall survival and progression-free survival, respectively, were observed at the 3-year interval in these patients. Detectability of peripheral blood measurable residual disease (MRD) continued to decrease as patients completed more cycles of ALR therapy. In addition, the clonal evolution of TP53 mutation subclones may explain observed resistance mechanisms based on cell-free DNA analyses.
Moreover, patients treated with the ALO regimen had a 90% objective response rate and complete response rate. They also had 100% overall survival and progression-free survival rates at the 1-year interval. Similarly, detectability of peripheral blood MRD continued to decrease as patients completed more cycles of ALO. Furthermore, treatment-related adverse events reported by patients included rash (42%), asymptomatic neutropenia (38%), anemia (4%), fatigue (4%), thrombocytopenia (4%), and vomiting (4%).
Disclosure: For full disclosures of the study authors, visit ash.confex.com.
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