Clinical Edge

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RB/RC induction followed by ASCT achieved high rates of durable MCL remissions

Key clinical point: The treatment was tolerated well overall along with the high rate of durable remissions.

Major finding: 3-year progression-free survival and overall survival were 83% and 92%, respectively.

Study details: A total of 88 patients received rituximab/bendamustine + rituximab/high-dose cytarabine (RB/RC).

Disclosures: The authors reported consulting for and receiving research funding from various pharmaceutical companies.

Commentary

β€œOne of the primary disadvantages of intensive regimens used in MCL is the fact that they require highly specialized care. In this article, Merryman and colleagues describe the pooled results of two clinical trials plus an off-trial cohort of patients treated with bendamustine-rituximab (BR) plus rituximab-cytarabine (RC) followed by autologous stem cell transplantation (ASCT). There was some heterogeneity in the dosing and schedule of the BR/RC regimen, but one version was used successfully in a community center. Transitioning at least part of MCL management to the community could significantly ease the burden on patients who live at a distance from tertiary care centers or who are unable to put their life on hold. The BR/RC regimen is currently being tested in the EA4181 trial along with BR/RC plus acalabrutinib and BR plus acalabrutinib. Together with the EA4151 trial, which is evaluating the role of ASCT, we may eventually find that many patients with MCL can be managed entirely in the community.”

Peter Martin, MD

Weill Cornell Medicine

Citation:

Merryman RW et al. Blood Adv. 2020 4(5):858–67.