Predictors and Implications of Rituximab Maintenance Failure in Mantle Cell Lymphoma

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Patients who did not reach a first complete remission were twice as likely to fail rituximab maintenance therapy; patients who received autologous stem cell transplant had a decreased failure risk of
Patients who did not reach a first complete remission were twice as likely to fail rituximab maintenance therapy; patients who received autologous stem cell transplant had a decreased failure risk of
The following article features coverage from the American Society of Hematology (ASH) 2017 meeting. Click here to read more of Cancer Therapy Advisor's conference coverage.

Patients with mantle cell lymphoma (MCL) who fail rituximab maintenance therapy have a greatly increased risk of death, according findings being presented at the 2017 American Society of Hematology (ASH) Annual Meeting in Atlanta, Georgia.1

For this study (ClinicalTrials.gov Identifier: NCT03199066), researchers identified 297 patients with treatment-naive MCL who had a complete response (CR) or partial response (PR) after receiving an induction regimen that contained rituximab, and were then maintained on rituximab. The median patient age was 66 years, and 22.2%, 34.1%, and 43.7% of patients had low, intermediate, and high MIPI [MCL International prognostic index] scores, respectively.

After a median follow-up of 3.8 years, 31.2% and 20.1% of patients relapsed/progressed or died, respectively. The 5-year overall survival (OS) was 75% (95% CI, 0.69-0.81), and 5-year progression-free survival (PFS) was 56% (95% CI, 0.49-0.63).

Approximately 67% of relapses/progressions and 41% of deaths occurred within 2 years of initiating rituximab maintenance therapy. The 2-year PFS and OS rates after initiating rituximab maintenance were 71.6% and 88.0%, respectively.

Patients who relapsed/progressed while on rituximab maintenance therapy had a significantly worsened 2-year OS rate of 70.3% compared with 91.7% among patients who did not relapse (hazard ratio [HR], 15.0; P < .001).

Patients who did not reach a first complete remission were twice as likely to fail rituximab maintenance therapy (HR, 2.23; P < .001), and patients who received autologous stem cell transplant had a decreased failure risk of 69% (HR, 0.31, P < .001). 

The authors concluded that “[i]n patients who are at risk of [rituximab maintenance] failure, an alternative maintenance strategy should be considered.”

Read more of Cancer Therapy Advisor's coverage of the American Society of Hematology (ASH) 2017 meeting by visiting the conference page.

Reference

  1. Obr A, Prochazka V, Papajik T, et al. Rituximab maintenance failure in mantle cell lymphoma is associated with high risk of death: analysis of the Czech Lymphoma Study Group (CLSG). Oral presentation at: American Society of Hematology 59th Annual Meeting & Exposition; December 9-12, 2017; Atlanta, GA.

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