Refractory mantle cell lymphoma (MCL) is a rare form of non-Hodgkin’s lymphoma affecting approximately 15,000 patients in the United States. MCL is difficult to treat, with limited treatment options due to the rapid development of chemoresistance against the most widely used therapy, Bortezomib.
In 2012, Dr. Michael Wang, MD, an Associate Professor at the University of Texas MD Anderson Cancer Center in Houston, presented interim data at the American Society of Hematology on a Phase II study testing Ibrutinib, a first-in-class, oral Bruton tyrosine kinase inhibitor, in patients with relapsed or refractory MCL.
The study, carried out across 18 sites in the United States and Europe, enrolled 110 patients of which 65 were classified as bortezomib-naive patients (where 89.2% has not received any previous therapy and 10.8% had received less than two cycles of bortezomib) and 50 patients had received at least two cycles of bortezomib.
After 9.2 months, 68% of these 110 patients exhibited a clinical response (CR). A CR of 21% was recorded for bortezomib-naive patients and 23% for bortezomib-exposed patients.
In 51 patients, where a longer follow-up of 14.7 months was available, 75% had a response, with a 40% CR being recorded in bortezomib-naive patients and 38% in bortezomib-exposed patients.
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This work was highlighted recently in Clinical Oncology News alongside results from a study on the potential use of Lenalidomide (Revlimid, Celgene) as a treatment option. In this report, the response rate for patients receiving lenalidomide were quoted as 30% whereas patients receiving ibrutinib, had response rate of 70%.
Dr. Wang, characterized the drug as well tolerated, stating that “most of the non-hematogenous toxicities were of grade 1 or grade 2.”
Joshua Brody, MD, an Assistant Professor in Hematology and Medical Oncology at Mount Sinai School of Medicine in New York City, said.” A number of exciting studies at this ASH meeting showed ibrutinib is effective in various cancers, including chronic lymphocytic leukemia. “Ibrutinib will likely be approved for this and other types of lymphoma and its role will evolve over the next few years, first into combination regimens for relapsed/refractory patients and then into primary therapy.”
Photo from http://path.upmc.edu.