270 | Real‐world Treatment Patterns and Outcomes in High‐risk, Treatment‐naive Mantle Cell Lymphoma: a Multinational Analysis From the Uk, Sweden, and France
Year: 2025
Type: article
Study design: Observational Study
Abstract: Introduction: Hallmark features of high-risk (HR) mantle cell lymphoma (MCL; eg, TP53 mutations, Ki67 ≥ 30%, blastoid/ pleomorphic [B/P] histology, HR MCL International Prognostic Index [MIPI] scores) impart a poor prognosis.In patients (pts) with HR MCL, evidence suggests limited benefit of standard chemoimmunotherapy (CIT), with improved outcomes seen with novel targeted therapies (eg, Bruton tyrosine kinase inhibitors).HR features are increasingly being proposed to guide treatment (tx) selection in these pts, underlining the need for continued assessment of tx patterns.Methods: This real-world (RW) retrospective observational study analyzed data from pts with first-line (1L) HR MCL in the UK from 2005-2021 using the Hematological Malignancy Research Network registry, in France (FR) from 2018-2022 using the Real-world Data in Lymphoma and Survival in Adults Database, and in Sweden (SE) from 2006-2018 using the Swedish Lymphoma Register.HR MCL was defined as MCL with any TP53 mutation(s), Ki67 ≥ 30%, B/P histology, or HR MIPI score.Pts in interventional studies were excluded.Outcomes of interest included demographic/clinical characteristics, RW 1L and second-line (2L) tx patterns, overall response rates (ORRs), event-free survival (EFS), and overall survival (OS).Results: A total of 2100 pts with 1L MCL were identified; 1029 (UK, n/N = 340/591; SE, n/N = 555/1214; FR, n/N = 134/295) had HR MCL and received 1L tx.Most pts were male and aged ≥ 65 y (Table).Specific HR features available varied, with 77.0%, 100%, and 100% of pts with HR MCL in the UK, SE, and FR, respectively, classified as high MIPI; Ki67 ≥ 30% reported in 34.8%, not available (NA), and 40.3%;B/P histology reported in 19.2%, 13.3%, and 12.7%; and TP53 mutations reported in 0.9%, NA, and NA (Table).1L tx is detailed in the Table .Rituximab (R) maintenance was reported in 21.9% of pts in the UK, 45.4% in SE, and 52.2% in FR. 1L ORRs were 55.8%, 64.9%, and 71.0%, respectively.At a median follow-up of 7.4, 1.5, and 2.4 y, RW median EFS/OS was 0.6/1.7 y in the UK, 1.2/2.1 y in SE, and 2.8 y/not reached in FR.In the UK, SE, and FR, 48.9%, 42.3%, and 26.9% of pts on 1L tx received 2L tx, respectively.In the 2L setting, ibrutinib � R was the most common tx in the UK (n = 65, 47.8%) and FR (n = 17, 47.2%; Table ).2L ORRs were 44.9%, 45.1%, and 34.3% in the UK, SE, and FR, respectively.RW 2L median EFS/OS was 0.4/0.8y in the UK, 0.5/1.1 y in SE, and 0.5/1.4y in FR.Conclusions: This RW study details pts with HR MCL who comprise ~45-58% of pts with MCL in the study databases.Heterogeneity in pt cohorts and availability/reporting of HR features, which led to variability in 1L outcomes in this study, may impair individualized tx approaches.Poorer outcomes were also seen in the 2L setting, suggesting a need for more effective tx in pts with HR MCL in the 1L setting.Greater understanding of the prognostic value of HR features may increase availability of testing and optimize tx selection.
Source: Hematological Oncology
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4411347085