Dr. Smith on the Rationale of the ECOG-ACRIN E1411 Trial in MCL

Mitchell R. Smith, MD, PhD, associate cancer center director for clinical investigations, chief, Division of Oncology and Blood Disorders, GW Cancer Center, clinical professor of medicine, GW School of Medicine and Health Sciences, discusses the rationale for the phase 2 ECOG-ACRIN E1411 trial (NCT01415752) in mantle cell lymphoma (MCL).

Findings from the ECOG-ACRIN E1411 trial, which were presented during the 2021 ASCO Annual Meeting, failed to demonstrate an improvement in overall response rate, complete response rate, or median progression-free survival with the addition of bortezomib (Velcade) to standard, frontline bendamustine plus rituximab (Rituxan; BVR) vs bendamustine/rituximab (BR) alone in older patients with MCL.

Older patients with MCL receive less aggressive chemotherapy compared with younger patients, says Smith. Typically, older patients receive BR followed by rituximab maintenance, Smith adds.

The study, which was conceptualized about 10 years ago, aimed to evaluate whether BR and/or rituximab maintenance therapy could be improved upon, Smith says. The 4-arm study randomized patients to BR followed by rituximab maintenance, BVR followed by rituximab maintenance, BR followed by maintenance with rituximab and lenalidomide (Revlimid), or BVR followed by maintenance with rituximab and lenalidomide, concludes Smith.