Ibrutinib in Combination With Rituximab for Indolent Clinical Forms of Mantle Cell Lymphoma (IMCL-2015): A Multicenter, Open-Label, Single-Arm, Phase II Trial

PURPOSE The need for an individualized management of indolent clinical forms in mantle cell lymphoma (MCL) is increasingly recognized. We hypothesized that a tailored treatment with ibrutinib in combination with rituximab (IR) could obtain significant responses in these patients. METHODS This is a m...

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Autores: Giné Soca, Eva, Cruz, Fátima de la, Jiménez Ubieto, Ana, López Jimenez, Javier, Martín García-Sancho, Alejandro, Terol, M. José, González Barca, Eva, Casanova, María, Fuente, Adolfo de la, Marín Niebla, Ana, Muntañola, Ana, González López, Tomás José, Aymerich Gregorio, Marta, Setoain Perego, Xavier, Cortés Romera, Montserrat, Rotger, Amanda, Rodríguez, Sonia, Medina Herrera, Alejandro, García Sanz, Ramón, Nadeu Prat, Ferran, Beà Bobet, Sílvia M., Campo Güerri, Elias, López Guillermo, Armando, The GELTAMO Group
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/187044
Acceso en línea:https://hdl.handle.net/2445/187044
Access Level:acceso abierto
Palabra clave:Rituximab
Limfomes
Assaigs clínics
Lymphomas
Clinical trials
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spelling Ibrutinib in Combination With Rituximab for Indolent Clinical Forms of Mantle Cell Lymphoma (IMCL-2015): A Multicenter, Open-Label, Single-Arm, Phase II TrialGiné Soca, EvaCruz, Fátima de laJiménez Ubieto, AnaLópez Jimenez, JavierMartín García-Sancho, AlejandroTerol, M. JoséGonzález Barca, EvaCasanova, MaríaFuente, Adolfo de laMarín Niebla, AnaMuntañola, AnaGonzález López, Tomás JoséAymerich Gregorio, MartaSetoain Perego, XavierCortés Romera, MontserratRotger, AmandaRodríguez, SoniaMedina Herrera, AlejandroGarcía Sanz, RamónNadeu Prat, FerranBeà Bobet, Sílvia M.Campo Güerri, EliasLópez Guillermo, ArmandoThe GELTAMO GroupRituximabLimfomesAssaigs clínicsRituximabLymphomasClinical trialsPURPOSE The need for an individualized management of indolent clinical forms in mantle cell lymphoma (MCL) is increasingly recognized. We hypothesized that a tailored treatment with ibrutinib in combination with rituximab (IR) could obtain significant responses in these patients. METHODS This is a multicenter single-arm, open-label, phase II study with a two-stage design conducted in 12 Spanish GELTAMO sites (ClinicalTrials.gov identifier: NCT02682641). Previously untreated MCL patients with indolent clinical forms defined by the following criteria were eligible: no disease-related symptoms, nonblastoid variants, Ki-67 < 30%, and largest tumor diameter <= 3 cm. Both leukemic non-nodal and nodal subtypes were recruited. Patients received ibrutinib 560 mg once daily and a total of eight doses of rituximab 375 mg/m(2). Ibrutinib could be discontinued after 2 years in the case of sustained undetectable minimal residual disease (MRD). The primary end point was the complete response (CR) rate achieved after 12 cycles according to Lugano criteria. RESULTS Fifty patients with MCL (male 66%; median age 65 years) were enrolled. After 12 cycles of treatment, 42 (84%; 95% CI, 74 to 94) patients had an overall response, including 40 (80%; 95% CI, 69 to 91) with CR. Moreover, undetectable MRD in peripheral blood was achieved in 87% (95% CI, 77 to 97) of cases. At 2 years, 24 of 35 evaluable patients (69%) could discontinue ibrutinib because of undetectable MRD. Four patients had disease progression; three were non-nodal MCL and carried high genomic complexity and TP53 mutations at enrollment. No unexpected toxicity was seen except one patient with severe aplastic anemia. CONCLUSION Frontline IR combination achieves a high rate of CRs and undetectable MRD in indolent clinical forms of MCL. Discontinuation seems appropriate in cases with undetectable MRD, except for TP53-mutated cases.American Society of Clinical Oncology (ASCO)2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/187044Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1200/JCO.21.02321Journal of Clinical Oncology, 2022, vol. 40, num. 11, p. 1196-1205https://doi.org/10.1200/JCO.21.02321cc by-nc-nd (c) Giné, Eva et al., 2022http://creativecommons.org/licenses/by-nc-nd/3.0/es/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1870442026-05-27T06:46:51Z
dc.title.none.fl_str_mv Ibrutinib in Combination With Rituximab for Indolent Clinical Forms of Mantle Cell Lymphoma (IMCL-2015): A Multicenter, Open-Label, Single-Arm, Phase II Trial
title Ibrutinib in Combination With Rituximab for Indolent Clinical Forms of Mantle Cell Lymphoma (IMCL-2015): A Multicenter, Open-Label, Single-Arm, Phase II Trial
spellingShingle Ibrutinib in Combination With Rituximab for Indolent Clinical Forms of Mantle Cell Lymphoma (IMCL-2015): A Multicenter, Open-Label, Single-Arm, Phase II Trial
Giné Soca, Eva
Rituximab
Limfomes
Assaigs clínics
Rituximab
Lymphomas
Clinical trials
title_short Ibrutinib in Combination With Rituximab for Indolent Clinical Forms of Mantle Cell Lymphoma (IMCL-2015): A Multicenter, Open-Label, Single-Arm, Phase II Trial
title_full Ibrutinib in Combination With Rituximab for Indolent Clinical Forms of Mantle Cell Lymphoma (IMCL-2015): A Multicenter, Open-Label, Single-Arm, Phase II Trial
title_fullStr Ibrutinib in Combination With Rituximab for Indolent Clinical Forms of Mantle Cell Lymphoma (IMCL-2015): A Multicenter, Open-Label, Single-Arm, Phase II Trial
title_full_unstemmed Ibrutinib in Combination With Rituximab for Indolent Clinical Forms of Mantle Cell Lymphoma (IMCL-2015): A Multicenter, Open-Label, Single-Arm, Phase II Trial
title_sort Ibrutinib in Combination With Rituximab for Indolent Clinical Forms of Mantle Cell Lymphoma (IMCL-2015): A Multicenter, Open-Label, Single-Arm, Phase II Trial
dc.creator.none.fl_str_mv Giné Soca, Eva
Cruz, Fátima de la
Jiménez Ubieto, Ana
López Jimenez, Javier
Martín García-Sancho, Alejandro
Terol, M. José
González Barca, Eva
Casanova, María
Fuente, Adolfo de la
Marín Niebla, Ana
Muntañola, Ana
González López, Tomás José
Aymerich Gregorio, Marta
Setoain Perego, Xavier
Cortés Romera, Montserrat
Rotger, Amanda
Rodríguez, Sonia
Medina Herrera, Alejandro
García Sanz, Ramón
Nadeu Prat, Ferran
Beà Bobet, Sílvia M.
Campo Güerri, Elias
López Guillermo, Armando
The GELTAMO Group
author Giné Soca, Eva
author_facet Giné Soca, Eva
Cruz, Fátima de la
Jiménez Ubieto, Ana
López Jimenez, Javier
Martín García-Sancho, Alejandro
Terol, M. José
González Barca, Eva
Casanova, María
Fuente, Adolfo de la
Marín Niebla, Ana
Muntañola, Ana
González López, Tomás José
Aymerich Gregorio, Marta
Setoain Perego, Xavier
Cortés Romera, Montserrat
Rotger, Amanda
Rodríguez, Sonia
Medina Herrera, Alejandro
García Sanz, Ramón
Nadeu Prat, Ferran
Beà Bobet, Sílvia M.
Campo Güerri, Elias
López Guillermo, Armando
The GELTAMO Group
author_role author
author2 Cruz, Fátima de la
Jiménez Ubieto, Ana
López Jimenez, Javier
Martín García-Sancho, Alejandro
Terol, M. José
González Barca, Eva
Casanova, María
Fuente, Adolfo de la
Marín Niebla, Ana
Muntañola, Ana
González López, Tomás José
Aymerich Gregorio, Marta
Setoain Perego, Xavier
Cortés Romera, Montserrat
Rotger, Amanda
Rodríguez, Sonia
Medina Herrera, Alejandro
García Sanz, Ramón
Nadeu Prat, Ferran
Beà Bobet, Sílvia M.
Campo Güerri, Elias
López Guillermo, Armando
The GELTAMO Group
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Rituximab
Limfomes
Assaigs clínics
Rituximab
Lymphomas
Clinical trials
topic Rituximab
Limfomes
Assaigs clínics
Rituximab
Lymphomas
Clinical trials
description PURPOSE The need for an individualized management of indolent clinical forms in mantle cell lymphoma (MCL) is increasingly recognized. We hypothesized that a tailored treatment with ibrutinib in combination with rituximab (IR) could obtain significant responses in these patients. METHODS This is a multicenter single-arm, open-label, phase II study with a two-stage design conducted in 12 Spanish GELTAMO sites (ClinicalTrials.gov identifier: NCT02682641). Previously untreated MCL patients with indolent clinical forms defined by the following criteria were eligible: no disease-related symptoms, nonblastoid variants, Ki-67 < 30%, and largest tumor diameter <= 3 cm. Both leukemic non-nodal and nodal subtypes were recruited. Patients received ibrutinib 560 mg once daily and a total of eight doses of rituximab 375 mg/m(2). Ibrutinib could be discontinued after 2 years in the case of sustained undetectable minimal residual disease (MRD). The primary end point was the complete response (CR) rate achieved after 12 cycles according to Lugano criteria. RESULTS Fifty patients with MCL (male 66%; median age 65 years) were enrolled. After 12 cycles of treatment, 42 (84%; 95% CI, 74 to 94) patients had an overall response, including 40 (80%; 95% CI, 69 to 91) with CR. Moreover, undetectable MRD in peripheral blood was achieved in 87% (95% CI, 77 to 97) of cases. At 2 years, 24 of 35 evaluable patients (69%) could discontinue ibrutinib because of undetectable MRD. Four patients had disease progression; three were non-nodal MCL and carried high genomic complexity and TP53 mutations at enrollment. No unexpected toxicity was seen except one patient with severe aplastic anemia. CONCLUSION Frontline IR combination achieves a high rate of CRs and undetectable MRD in indolent clinical forms of MCL. Discontinuation seems appropriate in cases with undetectable MRD, except for TP53-mutated cases.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/187044
url https://hdl.handle.net/2445/187044
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1200/JCO.21.02321
Journal of Clinical Oncology, 2022, vol. 40, num. 11, p. 1196-1205
https://doi.org/10.1200/JCO.21.02321
dc.rights.none.fl_str_mv cc by-nc-nd (c) Giné, Eva et al., 2022
http://creativecommons.org/licenses/by-nc-nd/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by-nc-nd (c) Giné, Eva et al., 2022
http://creativecommons.org/licenses/by-nc-nd/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv American Society of Clinical Oncology (ASCO)
publisher.none.fl_str_mv American Society of Clinical Oncology (ASCO)
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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