Triplet Combination Addresses Unmet Need in Small Study Population With Mantle Cell Lymphoma

Study results may indicate for a potential alternative treatment option to address the unmet needs for elderly patients with newly diagnosed mantle cell lymphoma (MCL), according to Michael Wang, MD.

Wang, a professor in the Department of Lymphoma and Myeloma at The University of Texas MD Anderson Cancer Center, discusses the unmet needs that the triplet combination of acalabrutinib (Calquence) plus venetoclax (Venclexta), and rituximab (Rituxan) looks to fill in MCL.

The safety and efficacy of this combination is currently being examined in the ongoing, multicenter, open-label study (NCT02717624), which enrolled 21 patients with MCL. Experts working on this study believe that the combination could improve upon frontline convention chemoimmunotherapy for this elderly patient population.

Wang noted that future trials require more patients to be enrolled in order to confirm the results. Despite this, the combination was deemed tolerable with high response rates. Additionally, 100% of patients responded to therapy, with a 90% complete response rate by PET scan.

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0:08 | The unmet needs of this population, which is elderly patients with a newly diagnosed MCL, in the past and until now, internationally, we are treating these patients with chemotherapy. This study gave us a good result with chemo-free therapy that has a very superb safety and efficacy profile. In order to replace chemotherapy, we have tried doublets. We have tried ibrutinib [Imbruvica] with rituximab in the frontline [setting]. We published this article recently in the Journal of Clinical Oncology, and the response rate is very high. However, the cardiotoxicity was noted with atrial fibrillation.

1:02 | Although the doublet is very efficacious, we think that with the triplicated chemo-free therapy in the frontline [setting], we will have a better efficacy analysis, and hopefully, without severe toxicities. This study just showed that the response rate could be so high and 100%, it cannot be better. The complete response is 90% by PET scan, it can hardly be better. The side effect profile was very tolerable. That's a good study, a wonderful combination with a safety profile and highest response rate that can be attained during the clinical trial. However, I want to note that we only have 21 patients in this trial. And in order to confirm this result, we need more patients in the future trials.