Future Directions for MCL Following Results From the TRIANGLE Study

Martin Dreyling, MD, Department of Internal Medicine III, LMU University Hospital Munich, in Germany, discusses the next steps for research with ibrutinib (Imbruvica) in the mantle cell lymphoma (MCL) space following the presentation of data from the phase 3 TRIANGLE study (NCT02858258).

A total of 870 patients were enrolled and randomized in the open-label TRIANGLE study between July 2016 and December 2020. Patients received either the previous standard treatment of 3 cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, prednisone)/R-DHAP (rituximab, dexamethasone, cytarabine, cisplatin) followed by ASCT (n = 288), the addition of ibrutinib to standard treatment (n = 292), or ibrutinib without ASCT (n = 290).

The median age among patients enrolled in the study was 57 years (range, 27-68). Additionally, 76% of the patients were male, and 87% had stage IV disease.

According to findings presented at the 2022 American Society of Hematology (ASH) Annual Meeting, adding ibrutinib to standard chemoimmunotherapy induction followed by autologous stem cell transplantation (ASCT) and 2 years of maintenance ibrutinib showed that it could improve outcomes vs standard chemoimmunotherapy induction and ASCT alone for younger patients with MCL.

Dreyling notes that following these promising data, 2 randomized trials plan to be activated in which patients with MCL will be randomized to receive the new standard of chemotherapy plus ibrutinib or treatment with no chemotherapy.

Transcription:

0:08 | I think the next steps will be inclusion in the guidelines [and] as we now have proven, get rid of part of the chemotherapy. What about getting rid of chemotherapy overall, and therefore, this is our next step. We will activate 2 randomized trials during the next 6 months or so and both will be randomized trials between the new standard which is chemo plus ibrutinib vs a non-chemo arm. These results will be interesting, but that's to be reported in 3 to 4 years from now.