Optimal Therapy for Type of B-Cell Malignancy

A recent study showed improved long-term survival outcomes and quality of life (QoL) for patients with mantle cell lymphoma (MCL) receiving tyrosine kinase inhibitor (TKI) therapy compared with those receiving standard of care.

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Less than 50% of patients with MCL achieve a complete response to current therapies. Previous studies have shown that temsirolimus improve progression-free survival and time to death compared with other therapies. However, limited data exists comparing temsirolimus and the TKI therapy ibrutinib in this disease setting.

A group of multinational researchers led by Georg Hess, MD, department of hematology, University Medical School of the Johannes Gutenberg University (Germany), conducted a phase III, randomized, open-label trial to compare the long-term safety and efficacy of ibrutinib vs temsirolimus in patients with previously treated, relapsed or refractory MCL. A total of 253 patients were sampled, 130 of whom received ibrutinib and 123 of whom received temsirolimus.

In addition to determining safety and efficacy, researchers employed the Functional Assessment of Cancer Therapy-Lymphoma (FACT-Lym) and the EQ-5D-5L patient questionnaires to assess symptoms, well-being, health status, and health-related QoL for patients receiving either therapy.

Results of the study were published in Leukemia &Lymphoma (online June 2017; doi:10.1080/10428194.2017.1326034).

Researchers found that patients in the ibrutinib cohort demonstrated reduced risk of disease progression by 57% compared with temsirolimus. Ibrutinib treatment also resulted in improved patient symptoms, at a faster rate than temsirolimus. Patients treated with ibrutinib lived a median of over 2 years without showing signs of disease progression, an average four times longer than those in the temsirolimus group.

Furthermore, patient-reported outcomes from the FACT-Lym and EQ-5D-5L questionnaires showed greater improvements in health-related QoL for those in the ibrutinib cohort. “These improvements in well-being correlated with clinical response, indicating that better health-related QoL was associated with decreased disease burden,” researchers wrote.

Authors of the study concluded that ibrutinib is more safe and effective than temsirolimus in previously treated, relapsed or refractory MCL and offers superior improvements in patient QoL.—Zachary Bessette