Department of Hematology, Oncology and Pneumology, Comprehensive Cancer Center, University Medical School of the Johannes Gutenberg-University, Mainz, Germany.
Medizinische Klinik III, LMU Klinikum, Munich, Germany.
Br J Haematol. 2023 Aug;202(4):749-759. doi: 10.1111/bjh.18519. Epub 2022 Oct 18.
Mantle cell lymphoma (MCL) after relapse is associated with poor prognosis. No standard of care exists and available evidence for treatments is limited, particularly in patients who fail Bruton tyrosine kinase inhibitor (BTKi) therapy. This multicentre retrospective chart review study, SCHOLAR-2, addresses this knowledge gap and reports on data collected from 240 patients with relapsed/refractory MCL in Europe who were treated with BTKi-based therapy between July 2012 and July 2018, and had experienced disease progression while on BTKi therapy or discontinued BTKi therapy due to intolerance. The median overall survival (OS) from initiation of first BTKi therapy was 14.6 months (95% confidence interval [CI] 11.6-20.0) in the overall cohort, 5.5 months (95% CI 3.9-8.2) in 91 patients without post-BTKi therapy, and 23.8 months (95% CI 18.9-30.1) in 149 patients who received post-BTKi therapy (excluding chimeric antigen receptor T-cell treatment). In the latter group, patients received a median of one (range, one to seven) line of post-BTKi therapy, with lenalidomide-containing regimens and bendamustine plus rituximab being the most frequently administered; the median OS from initiation of first post-BTKi therapy was 9.7 months (95% CI 6.3-12.7). These results provide a benchmark for survival in patients with R/R MCL receiving salvage therapy after BTKi failure.
套细胞淋巴瘤(MCL)复发后预后不良。目前尚无标准治疗方法,可用的治疗方法证据有限,尤其是在 Bruton 酪氨酸激酶抑制剂(BTKi)治疗失败的患者中。这项多中心回顾性图表研究,SCHOLAR-2,解决了这一知识空白,并报告了 2012 年 7 月至 2018 年 7 月期间在欧洲接受基于 BTKi 治疗的 240 例复发/难治性 MCL 患者的数据,这些患者在 BTKi 治疗期间或因不耐受而停止 BTKi 治疗后疾病进展。在整个队列中,从首次 BTKi 治疗开始的中位总生存期(OS)为 14.6 个月(95%置信区间[CI] 11.6-20.0),91 例无 BTKi 治疗后患者的中位 OS 为 5.5 个月(95%CI 3.9-8.2),149 例接受 BTKi 治疗后(不包括嵌合抗原受体 T 细胞治疗)的患者的中位 OS 为 23.8 个月(95%CI 18.9-30.1)。在后一组中,患者接受了中位数为一线(范围为一线至七线)的 BTKi 治疗后治疗,含来那度胺的方案和苯达莫司汀联合利妥昔单抗是最常使用的方案;从首次 BTKi 治疗开始的中位 OS 为 9.7 个月(95%CI 6.3-12.7)。这些结果为 BTKi 治疗失败后接受挽救性治疗的 R/R MCL 患者的生存提供了基准。