Abstract
The 2017 annual meeting of the American Society of Hematology took place 9–12 December in Atlanta, Georgia. At the meeting, results from key studies in the treatment of relapsed and refractory mantle cell lymphoma were presented. Of those studies, oral presentations focused on the efficacy and safety of therapy with Bruton tyrosine kinase (BTK) inhibitors. One study presented pooled data from three trials using ibrutinib, with a median follow-up of 3.5 years. A second phase ii study presented data on the efficacy and safety of acalabrutinib, a highly selective BTK inhibitor with minimal off-target activity. The final study presented early phase ib data on the efficacy and safety of zanubrutinib, a novel, highly selective BTK inhibitor, in patients with non-Hodgkin lymphoma. Our meeting report describes the foregoing studies and presents interviews with investigators and commentaries by Canadian hematologists about potential effects on Canadian practice.
Highlights
Mantle cell lymphoma is a rare and aggressive subtype of non-Hodgkin lymphoma
Four agents are approved for the treatment of relapsed or refractory mcl, including bortezomib (Velcade: Takeda Pharmaceutical Company, Osaka, Japan)[4], lenalidomide (Revlimid: Celgene Corporation, Summit, NJ, U.S.A.)[5], and ibrutinib (Imbruvica: Pharmacyclics Sunnyvale, CA, U.S.A.)[6] in the United States, and lenalidomide[5], temsirolimus (Torisel: Pfizer, New York, NY, U.S.A.),[7] and ibrutinib[8] in Europe
In Canada, only two agents are approved in this setting: bortezomib[9] and ibrutinib[10], which have received full marketing approval from Health Canada
Summary
Mantle cell lymphoma (mcl) is a rare and aggressive subtype of non-Hodgkin lymphoma (nhl). In younger (less than 60–65 years) fit patients, standard induction therapy is high-dose chemoimmunotherapy, with consolidation using high-dose therapy, followed by autologous stem-cell transplantation and maintenance ritux imab[1,3]. In elderly patients (60 – 65 years of age and older), or in those ineligible for transplantation, bendamustine–rituximab is the recommended treatment option, followed by rituximab maintenance. Four agents are approved for the treatment of relapsed or refractory (rr) mcl, including bortezomib (Velcade: Takeda Pharmaceutical Company, Osaka, Japan)[4], lenalidomide (Revlimid: Celgene Corporation, Summit, NJ, U.S.A.)[5], and ibrutinib (Imbruvica: Pharmacyclics Sunnyvale, CA, U.S.A.)[6] in the United States, and lenalidomide[5], temsirolimus (Torisel: Pfizer, New York, NY, U.S.A.),[7] and ibrutinib[8] in Europe. In Canada, only two agents are approved in this setting: bortezomib[9] and ibrutinib[10], which have received full marketing approval from Health Canada
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