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)
04/25/2026
DOI: 10.1038/s41408-026-01507-w
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)
- DOI
- 10.1038/s41408-026-01507-w
- PMID
- 42034605
- ISSN
- 2044-5385
- eISSN
- 2044-5385
- Publisher
- Springer Nature
- Language
- English
- Electronic publication date
- 04/25/2026
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Epidemiology; Internal Medicine
- Record Identifier
- 9985157503102771
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