Ibrutinib Highly Effective as First-Line Mantle Cell Lymphoma Treatment

Results of a large randomized trial support the inclusion of ibrutinib (Imbruvica) to the standard first-line treatment of younger patients with mantle cell lymphoma, according to research presented at the 2022 American Society of Hematology annual meeting.

In this exclusive MedPage Today video, Henry Fung, MD, of Fox Chase Cancer Center in Philadelphia, discusses the results of the three-arm TRIANGLE trial, which found similar 3-year failure-free survival rates in patients who received ibrutinib alone (86%) or with autologous stem-cell transplant (88%), both of which were numerically higher when compared with transplant alone (72%).

Following is a transcript of his remarks:

It is a great study that included almost 900 patients, which is phenomenal in mantle cell lymphoma, since mantle cell lymphoma is a rare disease — we only have 3,000-4,000 new cases each year in this country.

My response to the reaction to the report is that one: ibrutinib, a BTK [Bruton’s tyrosine kinase] inhibitor, is very important for younger patients in the treatment of mantle cell lymphoma. And it also suggested that maybe we don’t need autologous stem-cell transplant consolidations. The standard of care for now is high-dose chemotherapy, and then consolidation with autologous stem-cell transplant. And also very important is the continuation of treatment or maintenance.

And talking about autologous stem-cell transplant, I have a word of caution in the study, because only 35% of patients are Ki-67 more than 30%, and also only 15% of patients have a high MIPI [Mantle Cell Lymphoma International Prognostic Index] score. I’m not sure if we can definitely exclude stem-cell transplant for younger patients, which is a well-tolerated procedure. And this is my opinion.