A multicenter analysis of the outcomes with venetoclax in patients with relapsed mantle cell lymphoma Journal Article
| Authors: | Sawalha, Y.; Goyal, S.; Switchenko, J. M.; Romancik, J. T.; Kamdar, M.; Greenwell, I. B.; Hess, B. T.; Isaac, K. M.; Portell, C. A.; Garcia, A. M.; Goldsmith, S.; Grover, N. S.; Riedell, P. A.; Karmali, R.; Burkart, M.; Buege, M.; Akhtar, O.; Torka, P.; Kumar, A.; Hill, B. T.; Kahl, B. S.; Cohen, J. B. |
| Article Title: | A multicenter analysis of the outcomes with venetoclax in patients with relapsed mantle cell lymphoma |
| Abstract: | To report the activity of venetoclax in patients with relapsed mantle cell lymphoma (MCL), we identified 81 patients treated with venetoclax monotherapy (n = 50, 62%) or in combination with a Bruton tyrosine kinase inhibitor (BTKi) (n = 16, 20%), an anti-CD20 monoclonal antibody (n = 11, 14%), or other active agents at 12 US academic medical centers. Patients had high-risk disease features including Ki67 >30% (61%), blastoid/ pleomorphic histology (29%), complex karyotype (34%), and TP53 alterations (49%), and received a median of 3 prior treatments including BTKis in 91%. Venetoclax alone or in combination resulted in an overall response rate (ORR) of 40% and median progression-free (PFS) and overall survival (OS) of 3.7 and 12.5 months, respectively. The receipt of ≤3 prior treatments was associated with higher odds of response to venetoclax in a univariable analysis. In a multivariable analysis, having a high-risk Mantle Cell Lymphoma International Prognostic Index score before receiving venetoclax and disease relapse or progression within 24 months of diagnosis were associated with inferior OS whereas the use of venetoclax in combination was associated with superior OS. Although most patients (61%) had low risk for tumor lysis syndrome (TLS), 12.3% of patients developed TLS despite the implementation of several mitigation strategies. In conclusion, venetoclax resulted in good ORR but short PFS in patients with MCL who are at high risk, and may have a better role in earlier lines of treatment and/or in conation with other active agents. TLS remains an important risk in patients with MCL who initiate treatment with venetoclax. © 2023 by The American Society of Hematology. |
| Keywords: | adult; cancer survival; controlled study; treatment response; aged; gene mutation; major clinical study; overall survival; drug activity; cancer recurrence; cancer growth; monotherapy; cancer patient; outcome assessment; cancer diagnosis; ki 67 antigen; progression free survival; mantle cell lymphoma; cohort analysis; retrospective study; protein p53; histology; risk assessment; monoclonal antibody; tumor lysis syndrome; multicenter study; university hospital; karyotype; international prognostic index; overall response rate; cd20 antibody; human; male; female; article; venetoclax; mitigation; bruton tyrosine kinase inhibitor |
| Journal Title: | Blood Advances |
| Volume: | 7 |
| Issue: | 13 |
| ISSN: | 2473-9529 |
| Publisher: | American Society of Hematology |
| Date Published: | 2023-07-11 |
| Start Page: | 2983 |
| End Page: | 2993 |
| Language: | English |
| DOI: | 10.1182/bloodadvances.2022008916 |
| PUBMED: | 36809796 |
| PROVIDER: | scopus |
| PMCID: | PMC10320213 |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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