Although there remains an unmet need in patients with relapsed/refractory mantle cell lymphoma (MCL) after Bruton tyrosine kinase inhibitor (BTKi) treatment, brexucabtagene autoleucel (brexu-cel) is a promising therapy, according to research from the Eleventh Society of Hematologic Oncology Annual Meeting in Houston, Texas.
After performing a meta-analysis, a multinational group of researchers, including presenter Michael Wang, MD, of the University of Texas MD Anderson Cancer Center, found that pooled groups of patients who received brexu-cel had significantly better outcomes than groups of patients who had undergone nonchimeric antigen receptor (CAR) T-cell therapies.
In their study, the researchers sought to characterize and quantify the unmet need of patients with relapsed or refractory MCL in the post-BTKi setting by systematically searching the literature up to October 2022 and also searching select conferences. They gathered studies that included these types of patients who had received non-CAR-T treatments and reported survival rates and response outcomes. In a secondary analysis, they also identified and assessed studies reporting on brexu-cel results.
Ultimately, the researchers analyzed 26 studies from 2005 to 2022, including 23 observational studies and three trials. Most studies reported outcomes using patient cohorts that received a variety of non-CAR-T interventions. The studies also included mostly male patients (65%-94%) and a median age ranging from 63 to 77 years.
The patient groups receiving brexu-cel had better outcomes (see TABLE 1).
“Treatment options in the post-BTKi setting are heterogeneous and a significant unmet clinical need persists,” the researchers concluded. “Although longer follow-up is needed for survival outcomes, treatment with brexu-cel is emerging as a promising option in this difficult-to-treat setting.”
Dreyling M, Shah B, Wu J, et al. Unmet need in relapsed/refractory (RR) mantle cell lymphoma (MCL) post-Bruton tyrosine kinase inhibitor (BTKi): systematic literature review and meta-analysis. Abstract MCL-373. Presented at the Eleventh Annual Meeting of the Society of Hematologic Oncology; September 6-9, 2023; Houston, Texas.
|Treatment outcomes in relapsed/refractory MCL patients post-BKTi|
|Median overall survival||9.1 months (669 patients from 10 studies)||32.1 months (371 patients from 5 studies)|
|Median progression-free survival||7.6 months (371 patients from 3 studies)||14.9 months (418 patients from 6 studies)|
|Pooled objective response rate||45% (173/414 patients from 13 studies)||89% (482/546 patients from 7 studies)|
|Pooled complete response rate||23% (79/360 patients from 11 studies)||74% (408/546 patients from same 7 studies)|