TRIANGLE Study of Ibrutinib Shows High Efficacy in MCL

Martin Dreyling, MD, Department of Internal Medicine III, LMU University Hospital Munich, in Germany, discusses findings from the phase 3 TRIANGLE study (NCT02858258) of ibrutinib (Imbruvica) in patients with mantle cell lymphoma (MCL).

Data from the study were presented at the 2022 ASH Annual Meeting.

According to Dreyling, the addition of ibrutinib to standard chemoimmunotherapy induction followed by autologous stem cell transplantation (ASCT) and 2 years of maintenance ibrutinib can improve outcomes vs standard chemoimmunotherapy induction and ASCT alone for younger patients with MCL.

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0:08 | In this study, a huge study with almost 900 patients, we could show that first of all, the add on ARM A plus I, autologous transplant plus ibrutinib, did result not only in a statistically significant but also a clinically meaningful improvement of progression-free survival [PFS]. So after 3 years, it's in the range of 15%.

0:32 | The second comparison is autologous vs ibrutinib, interestingly. The predefined statistical question was superiority of autologous transplant. It's only worthwhile, the additional toxicity if it's significantly worse. Now to our surprise, the curves are flipping and therefore the ibrutinib arm is again about 50% improve PFS better after 3 years than the autologous transplant.

1:08 | The third question we don't know yet. If you take ibrutinib for granted, what about additional autologous transplant? But what we have seen in fact is that the combination maybe not totally unexpected, has an increased toxicity. Therefore the data as they are now, in my opinion, are clear that definitely the autofocus standalone arm is no more standard of care and the ibrutinib containing only arm is the best tolerated 1.