Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

R-BAC demonstrates a high response rate for MCL in the post-BTKi setting

Key clinical point: MCL patients progressing on Bruton’s tyrosine kinase inhibitor (BTKi) performed well on R‐BAC (rituximab, bendamustine, cytarabine).

Major finding: Overall response rate was 83% (complete response 60%) and 31% were bridged to allogeneic stem cell transplant (alloSCT).

Study details: A retrospective study of 36 MCL patients treated with R-BAC across 23 centers between Oct. 2015 and Mar. 2019.

Disclosures: Several of the authors reported research support, honoraria, and travel grants from a variety of pharmaceutical companies.

Commentary

“Our understanding and management of MCL following BTK inhibitor (BTKi) failure is constantly evolving. Early experience with BTK inhibitors was primarily in patients with an aggressive form of MCL that had emerged following multiple prior lines of therapy, and there were no great options following rapid progression associated with BTKi failure. Multiple publications confirmed the poor prognosis associated with BTKi failure and no clear winners emerged regarding post-BTKi treatment. As patients with less aggressive MCL receive BTKi earlier in the course of therapy, it makes sense that standard drugs appear to be working better. In addition to providing us with useful information on how these patients might be managed, reports like this one from the UK also provide a new context with which to consider the emerging data from CART cell studies like ZUMA-2.”

Peter Martin, MD

Weill Cornell Medicine