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Ibrutinib improves survival compared with chemotherapy in mantle cell lymphoma with central nervous system relapse

Identifikátory výsledku

  • Kód výsledku v IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064165%3A_____%2F22%3A10445035" target="_blank" >RIV/00064165:_____/22:10445035 - isvavai.cz</a>

  • Nalezeny alternativní kódy

    RIV/00064173:_____/22:43923706 RIV/00216208:11110/22:10445035 RIV/00216208:11120/22:43923706

  • Výsledek na webu

    <a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=4dZ.3NlpNf" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=4dZ.3NlpNf</a>

  • DOI - Digital Object Identifier

    <a href="http://dx.doi.org/10.1182/blood.2022015560" target="_blank" >10.1182/blood.2022015560</a>

Alternativní jazyky

  • Jazyk výsledku

    angličtina

  • Název v původním jazyce

    Ibrutinib improves survival compared with chemotherapy in mantle cell lymphoma with central nervous system relapse

  • Popis výsledku v původním jazyce

    Central nervous system (CNS) relapse of Mantle Cell Lymphoma (MCL) is a rare phenomenon with dismal prognosis, where no standard therapy exists. Since the covalent Bruton tyrosine kinase inhibitor ibrutinib is effective in relapsed/refractory MCL and it penetrates the blood-brain barrier (BBB), on behalf of Fondazione Italiana Linfomi and European Mantle Cell Lymphoma Network we performed a multicenter retrospective international study to investigate the outcomes of patients treated with ibrutinib or chemo-immunotherapy. In this observational study we recruited MCL patients with CNS involvement at relapse, who received CNS directed therapy between 2000 to 2019. The primary objective was to compare overall survival (OS) of patients treated with ibrutinib or BBB crossing chemotherapy. A propensity score based on a multivariable binary regression model was applied to balance treatment cohorts. Eighty-eight patients were included. Median age at study entry was 65 years (range: 39-87), 76% were males, and median time from lymphoma diagnosis to CNS relapse was 16 months (range: 1-122). Patients were treated with ibrutinib (n=29, ibrutinib cohort), BBB crossing chemotherapy, i.e. high-dose methotrexate +- cytarabine (n=29, BBB cohort), or miscellaneous treatments (n=30, other therapy cohort). Both median OS (16.8 versus 4.4 months; p=0.007) and median PFS (13.1 versus 3.0 months; p=0.009) were superior in the ibrutinib cohort as compared to BBB cohort. Multivariable Cox regression model revealed that ibrutinib therapeutic choice was the strongest independent favorable predictive factor for both OS (HR: 6.8, 95% CI: 2.2-21.3; p &lt;0.001) and PFS (HR 4.6, 95% CI: 1.7-12.5; p=0.002), followed by CNS progression of disease (POD) &gt; 24 months from first MCL diagnosis (HR for death: 2.4, 95% CI: 1.1-5.3; p=0.026; HR for death or progression: 2.3, CI 95%: 1.1-4.6; p=0.023). The addition of intrathecal chemotherapy to systemic CNS directed therapy was not associated with superior OS (p=0.502), as the morphological variant (classical versus others, p=0.118). Ibrutinib was associated with superior survival compared to BBB penetrating chemotherapy in patients with CNS relapse of MCL, and should be considered as a therapeutic option.

  • Název v anglickém jazyce

    Ibrutinib improves survival compared with chemotherapy in mantle cell lymphoma with central nervous system relapse

  • Popis výsledku anglicky

    Central nervous system (CNS) relapse of Mantle Cell Lymphoma (MCL) is a rare phenomenon with dismal prognosis, where no standard therapy exists. Since the covalent Bruton tyrosine kinase inhibitor ibrutinib is effective in relapsed/refractory MCL and it penetrates the blood-brain barrier (BBB), on behalf of Fondazione Italiana Linfomi and European Mantle Cell Lymphoma Network we performed a multicenter retrospective international study to investigate the outcomes of patients treated with ibrutinib or chemo-immunotherapy. In this observational study we recruited MCL patients with CNS involvement at relapse, who received CNS directed therapy between 2000 to 2019. The primary objective was to compare overall survival (OS) of patients treated with ibrutinib or BBB crossing chemotherapy. A propensity score based on a multivariable binary regression model was applied to balance treatment cohorts. Eighty-eight patients were included. Median age at study entry was 65 years (range: 39-87), 76% were males, and median time from lymphoma diagnosis to CNS relapse was 16 months (range: 1-122). Patients were treated with ibrutinib (n=29, ibrutinib cohort), BBB crossing chemotherapy, i.e. high-dose methotrexate +- cytarabine (n=29, BBB cohort), or miscellaneous treatments (n=30, other therapy cohort). Both median OS (16.8 versus 4.4 months; p=0.007) and median PFS (13.1 versus 3.0 months; p=0.009) were superior in the ibrutinib cohort as compared to BBB cohort. Multivariable Cox regression model revealed that ibrutinib therapeutic choice was the strongest independent favorable predictive factor for both OS (HR: 6.8, 95% CI: 2.2-21.3; p &lt;0.001) and PFS (HR 4.6, 95% CI: 1.7-12.5; p=0.002), followed by CNS progression of disease (POD) &gt; 24 months from first MCL diagnosis (HR for death: 2.4, 95% CI: 1.1-5.3; p=0.026; HR for death or progression: 2.3, CI 95%: 1.1-4.6; p=0.023). The addition of intrathecal chemotherapy to systemic CNS directed therapy was not associated with superior OS (p=0.502), as the morphological variant (classical versus others, p=0.118). Ibrutinib was associated with superior survival compared to BBB penetrating chemotherapy in patients with CNS relapse of MCL, and should be considered as a therapeutic option.

Klasifikace

  • Druh

    J<sub>imp</sub> - Článek v periodiku v databázi Web of Science

  • CEP obor

  • OECD FORD obor

    30205 - Hematology

Návaznosti výsledku

  • Projekt

    <a href="/cs/project/NU21-03-00386" target="_blank" >NU21-03-00386: Inovativní léčebné postupy a mechanismy lékové rezistence u lymfomu z plášťových buněk</a><br>

  • Návaznosti

    P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Ostatní

  • Rok uplatnění

    2022

  • Kód důvěrnosti údajů

    S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Údaje specifické pro druh výsledku

  • Název periodika

    Blood

  • ISSN

    0006-4971

  • e-ISSN

    1528-0020

  • Svazek periodika

    140

  • Číslo periodika v rámci svazku

    17

  • Stát vydavatele periodika

    US - Spojené státy americké

  • Počet stran výsledku

    10

  • Strana od-do

    1907-1916

  • Kód UT WoS článku

    000922881000008

  • EID výsledku v databázi Scopus

    2-s2.0-85138866143