Journal article
Mantle cell lymphoma outcomes following sequential first-line bendamustine-rituximab and second-line Bruton's tyrosine kinase inhibitor therapy
Blood cancer journal (New York), Vol.16(1), 93
2026
DOI: 10.1038/s41408-026-01507-w
PMCID: PMC13246765
PMID: 42034605
Abstract
Addition of Bruton's tyrosine kinase inhibitor (BTKi) to first-line (1 L) bendamustine-rituximab (BR) improved progression-free survival (PFS) in patients with mantle cell lymphoma (MCL) in the SHINE and ECHO trials. We investigated whether sequential treatment with 1 L BR and second-line (2 L) BTKi can result in similar cumulative PFS compared to BR-BTKi combination therapy, using a multicenter cohort of 755 patients treated with 1 L BR between 2014 and 2020. Event-free survival (EFS), EFS2, and overall survival (OS) were analyzed. By intention-to-treat (ITT), EFS2 was defined as time from 1 L BR start to progression/relapse or retreatment following 2 L BTKi or death. After a median follow-up of 61.4 (95% CI 56.4-65.9) months, the median EFS after 1 L BR was 34.2 (95% CI 31.5-38.4) months. The median EFS2 following 1 L BR and 2 L BTKi by ITT analysis was 64.8 (95% CI 56.7-82.8) months, and the 5-year OS rate after 1 L BR was 57.9% (95% CI 54.1-62.0%), close to SHINE and ECHO results. Patients without high-risk features (high simplified MIPI, high Ki-67, blastoid/pleomorphic morphology, TP53 mutation, or complex karyotype) had more favorable survival outcomes. These results suggest that sequential treatment with 1 L BR and 2 L BTKi remains reasonable for select patients with MCL, particularly those without high-risk features.
Details
- Title: Subtitle
- Mantle cell lymphoma outcomes following sequential first-line bendamustine-rituximab and second-line Bruton's tyrosine kinase inhibitor therapy
- Creators
- Yucai Wang - Mayo Clinic in ArizonaMelissa C Larson - Mayo Clinic in ArizonaSteven R Hwang - Mayo Clinic in ArizonaDiego Villa - University of British ColumbiaLaveniya Kugathasan - Spinal Cord Injury BCAnita Kumar - Memorial Sloan Kettering Cancer CenterAshlee Joseph - Memorial Sloan Kettering Cancer CenterTaylor R Brooks - Cleveland ClinicBrian T Hill - Cleveland ClinicDavid A Bond - The Ohio State UniversityKami J Maddocks - The Ohio State UniversityAlexey Danilov - City Of Hope National Medical CenterChristine Argao - City Of Hope National Medical CenterJia Ruan - Weill Cornell MedicineImran A Nizamuddin - Washington University in St. LouisBrad S Kahl - Washington University in St. LouisNatalie S Grover - University of North Carolina at Chapel HillNazneen B Khan - University of North Carolina at Chapel HillGeorgios N Pongas - University of MiamiIzidore S Lossos - University of MiamiEvguenia Ouchveridze - University of Kansas Medical CenterAung M Tun - University of Kansas Medical CenterFiras Baidoun - Mayo Clinic in FloridaMuhamad Alhaj Moustafa - Mayo ClinicZoey I Harris - Mayo Clinic HospitalJavier L Munoz - Mayo Clinic HospitalPhilip R Young - University of VirginiaCraig A Portell - University of VirginiaPatrick M Reagan - University of RochesterChristine E Ryan - Dana-Farber Cancer InstituteReid W Merryman - Dana-Farber Cancer InstituteArash Velayati - Medical University of South CarolinaI Brian Greenwell - Medical University of South CarolinaDrew G Gerber - Emory UniversityPreetesh Jain - The University of Texas MD Anderson Cancer CenterMichael L Wang - The University of Texas MD Anderson Cancer CenterSabarish R Ayyappan - University of IowaEric Mou - University of IowaLauren G Banaszak - University of Wisconsin–MadisonPriyanka A Pophali - University of Wisconsin–MadisonAnthony C Stack - Fox Chase Cancer CenterMarcus R Messmer - Fox Chase Cancer CenterMayur S Narkhede - University of Alabama at BirminghamAmitkumar Mehta - University of Alabama at BirminghamTamara K Moyo - Levine Cancer InstituteNilanjan Ghosh - Levine Cancer InstituteRahul S Bhansali - University of PennsylvaniaStefan K Barta - University of PennsylvaniaManali K Kamdar - University of Colorado DenverJacob Anna - University of Colorado Anschutz Medical CampusAlexander V Stanisic - Northwestern UniversityReem Karmali - Northwestern UniversityMatthew J Maurer - Mayo Clinic in ArizonaJames R Cerhan - Mayo Clinic in ArizonaJonathon B Cohen - Emory UniversityPeter Martin - Weill Cornell Medicine
- Resource Type
- Journal article
- Publication Details
- Blood cancer journal (New York), Vol.16(1), 93
- DOI
- 10.1038/s41408-026-01507-w
- PMID
- 42034605
- PMCID
- PMC13246765
- NLM abbreviation
- Blood Cancer J
- ISSN
- 2044-5385
- eISSN
- 2044-5385
- Publisher
- Springer Nature
- Grant note
- Lymphoma Research Foundation Clinical Investigator Career Development Award Blood Cancer United
We thank the clinical teams who cared for the patients included in this study and thank the research coordinators who helped with data collection. Dr. Yucai Wang is a recipient of Lymphoma Research Foundation Clinical Investigator Career Development Award. Dr. Anita Kumar is a Scholar in Clinical Research supported by Blood Cancer United.
- Language
- English
- Electronic publication date
- 04/25/2026
- Date published
- 2026
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Epidemiology; Internal Medicine
- Record Identifier
- 9985157503102771
Metrics
1 Record Views