Ibrutinib in mantle cell lymphoma: a real-world retrospective multi-center analysis of 77 patients treated in the Czech Republic

• Published in: Annals of hematology 2023-01, Vol.102 (1), p.107-115
• Main Authors: Obr, Ales, Benesova, Katerina, Janikova, Andrea, Mocikova, Heidi, Belada, David, Hruskova, Andrea, Vockova, Petra, Salek, David, Sykorova, Alice, Furst, Tomas, Malarikova, Diana, Papajik, Tomas, Trneny, Marek, Klener, Pavel
• Format: Article
• Language: English
• Subjects: Adult; Czech Republic; Female; Hematology; Humans; Inhibitor drugs; Ki-67 Antigen; Lymphoma; Lymphoma, Mantle-Cell - pathology; Medicine; Medicine & Public Health; Metabolism; Oncology; Original; Original Article; Positron Emission Tomography Computed Tomography; Targeted cancer therapy
• ISSN: 0939-5555; 1432-0584
• DOI: 10.1007/s00277-022-05023-2

Ibrutinib revolutionized therapy for relapsed/refractory (R/R) mantle cell lymphoma (MCL). Real-world data on the outcome of unselected patients are still limited. We analyzed 77 R/R MCL patients receiving ibrutinib with at least one prior systemic anti-lymphoma therapy. After a median follow-up of 14.0 months, 56 patients relapsed/progressed, and 45 died. The overall response rate was 66%, with 31% of complete metabolic remissions on PET/CT. The median progression-free and overall survival (OS) rates were 10.3 and 23.1 months, respectively. The median OS from ibrutinib failure was 3.7 months. High proliferation rate by Ki67 (≥ 30%) and two or more previous therapy lines both negatively correlated with outcome (HR = 2.2, p  = 0.04, and HR = 2.06, p  = 0.08, respectively). Female gender borderline correlated with better outcome (HR = 0.53, p  = 0.08). In multivariate analysis, Ki67 and response to ibrutinib both correlated with OS ( p