Outcomes in first relapsed-refractory younger patients with mantle cell lymphoma: results from the MANTLE-FIRST study

Visco, Carlo; Rocco, Alice Di; Evangelista, Andrea; Quaglia, Francesca Maria; Tisi, Maria Chiara; Morello, Lucia; Zilioli, Vittorio Ruggero; Rusconi, Chiara; Hohaus, Stefan; Sciarra, Roberta; Re, Alessandro; Tecchio, Cristina; Chiappella, Annalisa; Marín‐Niebla, Ana; McCulloch, Rory; Gini, Guido; Perrone, Tommasina; Nassi, Luca; Pennese, Elsa; Stefani, Piero Maria; Cox, Maria Christina; Bozzoli, Valentina; Fabbri, Alberto; Polli, Valentina; Ferrero, Simone; Celis, Maria Isabel Alvarez De; Sica, Antonello; Petrucci, Luca; Arcaini, Luca; Rule, Simon; Krampera, Mauro; Vitolo, Umberto; Balzarotti, Monica

doi:10.1038/s41375-020-01013-3

Cited by 72 publications

(85 citation statements)

References 26 publications

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“…According to international guidelines, patients with ALCL ALK +, once a CR at a rescue therapy has been obtained, must undergo allo-SCT, which could have a high chance of success [ 31 , 32 , 33 , 34 , 35 ]. The young age of the patient and her refractory to the first- and second-line treatments prompted us to proceed toward allo-SCT, so far without success, due to the unsuitability of the contacted donors [ 36 , 37 , 38 , 39 ]. Although in fair condition after 16 cycles of Brentuximab, fearing that even this third-line treatment would fail while waiting for a suitable donor, we decided to use crizotinib [ 40 , 41 , 42 , 43 ], a drug that, in Italy, is not registered for this type of lymphoma, but with a specific action against ALK + and effective in published anecdotal cases.…”

Section: Discussionmentioning

confidence: 99%

How Fear of COVID-19 Can Affect Treatment Choices for Anaplastic Large Cell Lymphomas ALK+ Therapy: A Case Report

et al. 2021

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Background: The t (2; 5) chromosomal rearrangement of the ALK gene with nucleophosmin 1 gene (NPM1), resulting in an NPM1–ALK fusion, was first demonstrated in 1994 in anaplastic large cell lymphoma, (ALCL), a T-cell lymphoma responsive to cyclophosphamide, abriblastine, vincristine and prednisone in approximately 80% of cases; refractory cases usually respond favorably to brentuximab vedotin. These treatments are regarded as a bridge to allogeneic hematopoietic stem cell transplantation (allo-SCT). Nowadays, transplant procedures and the monitoring of chemotherapy patients proceed very slowly because the SARS-CoV-2 pandemic has heavily clogged the hospitals in all countries. Results: A 40-year-old Caucasian woman was first seen at our clinical center in June 2020. She had ALCL ALK+, a history of failure to two previous therapeutic lines and was in complete remission after 12 courses of brentuximab, still pending allo-SCT after two failed donor selections. Facing a new therapeutic failure, we requested and obtained authorization from the Italian drug regulatory agency to administer 250 mg of crizotinib twice a day, a drug incomprehensibly not registered for ALCL ALK +. Conclusions: The response to crizotinib was optimal since no adverse event occurred, and CT-PET scans persisted negative; this drug has proved to be a valid bridge to allo-SCT.

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Section: Discussionmentioning

confidence: 99%

How Fear of COVID-19 Can Affect Treatment Choices for Anaplastic Large Cell Lymphomas ALK+ Therapy: A Case Report

et al. 2021

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“…65 A retrospective analysis of 258 patients with R/R MCL receiving ibrutinib supports the notion of particularly good outcomes with the use of ibrutinib in the second-line setting, although analysis was limited to a single institution. 106 Another retrospective analysis of patients who received ibrutinib as second-line therapy (n = 169) further demonstrated its utility in this setting in a sample with poor prognostic features (median age = 72 years, 23% with ECOG performance status 2 or higher). 107 Although PFS and OS appeared worse than those seen in clinical trials (median 16.5 and 23.9 months, respectively)—likely reflective of real-world experience in poorer-risk patients—PFS with ibrutinib nevertheless exceeded PFS with frontline therapy in nearly half of the patients.…”

Section: Developments In the Management Of Relapsed Or Refractory Dismentioning

confidence: 98%

Management of Mantle Cell Lymphoma in the Era of Novel Oral Agents

et al. 2020

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Objectives: To discuss (1) recent and emerging data for pharmacological management of untreated and relapsed/refractory (R/R) mantle cell lymphoma (MCL) with agents approved in the United States, (2) important considerations for toxicity monitoring and management, and (3) preliminary data and ongoing studies for agents in MCL-specific clinical trials. Data Sources: PubMed/MEDLINE, EMBASE, Google Scholar, product labeling, National Comprehensive Cancer Network, American Cancer Society, and ClinicalTrials.gov were searched for studies published between January 1, 2017, and January 31, 2020, and key historical trials. Study Selection and Data Extraction: Relevant studies conducted in humans and selected supporting preclinical data were reviewed. Data Synthesis: MCL is a rare but usually aggressive non-Hodgkin lymphoma that most commonly affects the older population. Traditionally, the treatment of MCL has been determined based on transplant eligibility. Newer data suggest that more tolerable frontline therapy may produce outcomes similar to intensive historical induction regimens, possibly precluding fewer patients from autologous stem cell transplant and producing better long-term outcomes in transplant-ineligible patients. In the R/R setting, novel regimens are improving outcomes and changing the landscape of treatment. Relevance to Patient Care and Clinical Practice: This review summarizes and discusses recent and emerging data for management of newly diagnosed and R/R MCL; key supportive care considerations for agents are also discussed. Conclusions: Recent study results are changing management of MCL. Although these data have complicated the picture of regimen selection, increasingly effective and tolerable therapy and additional anticipated data point to a brighter future for patients with MCL.

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“…The international retrospective “Mantle First” study, including 258 MCL patients in first relapse, evaluated outcome after second line treatment comparing ibrutinib, R-BAC, R-bendamustine or other approaches. A poorer outcome was observed in patients with early POD independently of the second line regimen; again, in this subgroup, allo-SCT conferred an advantage in terms of survival [ 28 ]. On the other hand, in a series of 360 patients, the EBMT reported that remission duration after ASCT significantly affected the outcome of salvage allo-SCT: in fact, patients who relapsed less than one year after ASCT had a poor prognosis, even if treated with allo-SCT [ 29 ].…”

Section: Which Is the Best Time For Allo-sct?mentioning

confidence: 99%

Allogeneic Stem Cell Transplantation in Mantle Cell Lymphoma in the Era of New Drugs and CAR-T Cell Therapy

Marangon

Visco

Barbui

et al. 2021

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MCL is an uncommon lymphoproliferative disorder that has been regarded as incurable since its identification as a distinct entity. Allogeneic transplantation for two decades has represented the only option capable of ensuring prolonged remissions and possibly cure. Despite its efficacy, its application has been limited by feasibility limitations and substantial toxicity, particularly in elderly patients. Nevertheless, the experience accumulated over time has been wide though often scattered among retrospective and small prospective studies. In this review, we aimed at critically revise and discuss available evidence on allogeneic transplantation in MCL, trying to put available evidence into the 2020 perspective, characterized by unprecedented development of novel promising therapeutic agents and regimens.

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Outcomes in first relapsed-refractory younger patients with mantle cell lymphoma: results from the MANTLE-FIRST study

Cited by 72 publications

References 26 publications

How Fear of COVID-19 Can Affect Treatment Choices for Anaplastic Large Cell Lymphomas ALK+ Therapy: A Case Report

How Fear of COVID-19 Can Affect Treatment Choices for Anaplastic Large Cell Lymphomas ALK+ Therapy: A Case Report

Management of Mantle Cell Lymphoma in the Era of Novel Oral Agents

Allogeneic Stem Cell Transplantation in Mantle Cell Lymphoma in the Era of New Drugs and CAR-T Cell Therapy

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