Dr. Visco on Results from the MANTLE-FIRST Study in Relapsed/Refractory MCL

Carlo Visco, MD, an associate professor within the Department of Medicine and Section of Hematology at the University of Verona, in Verona, Italy, discusses the results of early relapse versus late relapse in the MANTLE-FIRST study with ibrutinib (Imbruvica)versus chemoimmunotherapy in mantle cell lymphoma (MCL).

In the MANTLE-FIRST study, investigators evaluated outcomes in patients with MCL who were in first relapse following up-front treatment with high-dose cytarabine and standard regimens. Patients were divided into those who are early-progressors (POD), or those who were refractory to standard induction, and those who relapsed or progressed within 2 years from their lymphoma diagnosis, says Visco.

The 2 cohorts consisted of patients with early POD and those who relapse later on and up to 2 years. These 2 populations are very different in terms of survival, according to Visco. Those with early relapse disease typically have a median overall survival (OS) around 2 years from the time of relapse while those with late relapse disease have a life expectancy that is much longer, of around 5 years or more, Visco adds.

It is important to remember that those with early-relapse disease have an unmet need. The main takeaway from the MANTLE-FIRST trial was that when patients were divided between early or late relapse, ibrutinib was favorable compared with standard chemoimmunotherapy in terms of survival, according to Visco. This approach conferred a progression-free survival and OS advantage when given in the second-line setting, concludes Visco.