Dr. Phillips on Emerging Combination in MCL

Tycel J. Phillips, MD
Published: Thursday, Dec 20, 2018



Tycel J. Phillips, MD, assistant professor, University of Michigan Cancer Center, discusses an emerging treatment combination for patients with mantle cell lymphoma (MCL).

MCL is a rare subset of non–Hodgkin lymphoma (NHL) that affects about 5% to 6% of patients with NHL, Phillips says, although it is more commonly seen in male patients who are >65 years old. Currently, there is not a well-established standard of care for these patients, but a lot of ongoing research is geared toward addressing this unmet need in both transplant-eligible and -ineligible patients.

In terms of chemotherapy, bendamustine has proven to be an effective regimen with rituximab (Rituxan) maintenance, while in the relapsed/refractory setting, BTK inhibitors have shown promise, particularly with the rise of the second-generation inhibitor acalabrutinib (Calquence).

In a study presented at the 2018 ASH Annual Meeting, patients received oral acalabrutinib 100 mg twice daily, bendamustine at 90 mg/m2intravenously on days 1 and 2, and rituximab at 375 mg/m2 on day 1 in each 28-day cycle. Acalabrutinib was given until disease progression or intolerance and BR was repeated every 28 days for up to 6 cycles.

In previously untreated patients, the overall response rate (ORR) was 94% and complete response rate (CR) was 72% with the combination, while the relapsed/refractory arm had an ORR of 85% and a CR rate of 65%.
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Tycel J. Phillips, MD, assistant professor, University of Michigan Cancer Center, discusses an emerging treatment combination for patients with mantle cell lymphoma (MCL).

MCL is a rare subset of non–Hodgkin lymphoma (NHL) that affects about 5% to 6% of patients with NHL, Phillips says, although it is more commonly seen in male patients who are >65 years old. Currently, there is not a well-established standard of care for these patients, but a lot of ongoing research is geared toward addressing this unmet need in both transplant-eligible and -ineligible patients.

In terms of chemotherapy, bendamustine has proven to be an effective regimen with rituximab (Rituxan) maintenance, while in the relapsed/refractory setting, BTK inhibitors have shown promise, particularly with the rise of the second-generation inhibitor acalabrutinib (Calquence).

In a study presented at the 2018 ASH Annual Meeting, patients received oral acalabrutinib 100 mg twice daily, bendamustine at 90 mg/m2intravenously on days 1 and 2, and rituximab at 375 mg/m2 on day 1 in each 28-day cycle. Acalabrutinib was given until disease progression or intolerance and BR was repeated every 28 days for up to 6 cycles.

In previously untreated patients, the overall response rate (ORR) was 94% and complete response rate (CR) was 72% with the combination, while the relapsed/refractory arm had an ORR of 85% and a CR rate of 65%.

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