Survival with Axicabtagene Ciloleucel in Large B-Cell Lymphoma
CAR-T for second line is better than standard of care, the question is: how about compared to BITE therapy? Future is exciting for those patients.
Ibrutinib, a Bruton’s tyrosine kinase inhibitor, may have clinical benefit when administered in combination with bendamustine and rituximab and followed by rituximab maintenance therapy in older patients with untreated mantle-cell lymphoma.
We randomly assigned patients 65 years of age or older to receive ibrutinib (560 mg, administered orally once daily until disease progression or unacceptable toxic effects) or placebo, plus six cycles of bendamustine (90 mg per square meter of body-surface area) and rituximab (375 mg per square meter). Patients with an objective response (complete or partial response) received rituximab maintenance therapy, administered every 8 weeks for up to 12 additional doses. The primary end point was progression-free survival as assessed by the investigators. Overall survival and safety were also assessed.
Among 523 patients, 261 were randomly assigned to receive ibrutinib and 262 to receive placebo. At a median follow-up of 84.7 months, the median progression-free survival was 80.6 months in the ibrutinib group and 52.9 months in the placebo group (hazard ratio for disease progression or death, 0.75; 95% confidence interval, 0.59 to 0.96; P=0.01). The percentage of patients with a complete response was 65.5% in the ibrutinib group and 57.6% in the placebo group (P=0.06). Overall survival was similar in the two groups. The incidence of grade 3 or 4 adverse events during treatment was 81.5% in the ibrutinib group and 77.3% in the placebo group.
Ibrutinib treatment in combination with standard chemoimmunotherapy significantly prolonged progression-free survival. The safety profile of the combined therapy was consistent with the known profiles of the individual drugs. (Funded by Janssen Research and Development and Pharmacyclics; SHINE ClinicalTrials.gov number,
CAR-T for second line is better than standard of care, the question is: how about compared to BITE therapy? Future is exciting for those patients.
Pembrolizumab in lymphoma, this is not a common one, usually in young females, could be hard to treat.
5-year survival data from the Zuma trials shows that there is curative potential in r/r DLBCL with cure rates near 50%.
Not a common disease and not a randomized study, but very good responses seen in oral-Vidaza + CHOP for PTCL.
Is ibrutininb’s days as a treatment for CLL over? Zanubrutinib is more effective and less toxic.
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