ZANUBRUTINIB PLUS BENDAMUSTINE AND CD20 MONOCLONAL ANTIBODY AS TREATMENT FOR MANTLE CELL LYMPHOMA

Abstract

Introduction: To evaluate the safety and efficacy of Zanubrutinib Plus Bendamustine and CD20 monoclonal antibody As Treatment for Mantle Cell Lymphoma patients. Methods: We analyzed 15 MCL patients aged who received ZBR/G as treatment in our cohort between July 2020 to March 2023. 12(80%) patients received ZBR/G as their initial treatment, while 3 patients received ZBR/G as their 2nd line treatment. Oral Zanubrutinib was given continuously (160 mg twice a day) from day 0, then intravenously rituximab (375 mg/m2 in day 0) or Obinutuzumab (1000 mg in day 0), Bendamustine (70 mg/m2, days 1–2), every 28-day cycles. All the patients received 6 cycles of ZBR/G. Results: The median follow-up was 14.3 months. 13 of 15 patients achieved mid-term evaluation. Generally, the best overall response rate (ORR) was 100%, among which 61.5% patients achieved CR. Eight patients completed EOT evaluation after 6 cycles, the best overall response rate (ORR) was 100% and 75% patients achieved CR. Among them, one patient whose efficacy was evaluated as PR after 6 cycles reached CR after 3 cycles of rituximab maintenance. Four patients with bone marrow involvement at baseline and CR at mid-term evaluation all achieved uMRD in bone marrow. In terms of adverse events (AEs), two patients had grade 3 and grade 4 neutropenia AEs in cycle 3 and 4 respectively, and no other grade 3–4 AEs were observed. Four cases of classical type and mother cell variant were submitted for ctDNA detection. The mutation map of 8 patients is shown in Figure 1, and 5 cases (62.5%) detected ATM gene mutations. Among them, 2 patients with classic type had CCND1 gene mutation. Two patients had matched sequencing data at baseline and evaluation time points, which were evaluated as CR and PR respectively, and the plasma mutation abundance was significantly lower than before (Figure 2). The research was funded by: This study was supported by National Natural Science Foundation of China (Grant No. 82170166, No. 82100207, No. 81970146) Keyword: Combination Therapies No conflicts of interests pertinent to the abstract.