ECHO trial: Acalabrutinib plus bendamustine and rituximab for newly diagnosed older patients with MCL

Results from the phase III ECHO trial (NCT02972840) of acalabrutinib (A) plus bendamustine (B) and rituximab (R) vs placebo (Pbo) plus B and R in patients with newly diagnosed mantle cell lymphoma (MCL) were presented at the European Hematology Association (EHA) 2024 Hybrid Congress by Michael Wang.¹

The phase III ECHO trial met its primary endpoint of progression-free survival (PFS).

With a median follow-up of 45 months (mo), the PFS was 66.4 mo vs 49.6 mo in the A+B+R and Pbo+B+R arms, respectively (p = 0.0160).

Overall response rates were 91% (complete response [CR], 66.6%) vs 88% (CR, 53.5%) in the A+B+R and Pbo+B+R arms, respectively.

Overall survival (OS) was not reached in the A+B+R or Pbo+B+R arms (HR, 0.86; 95% confidence interval [CI], 0.65–1.13; p = 0.2743).

The safety profile of A+B+R was consistent with that of the individual agents.

Gr ≥3 AEs were comparable between A+B+R and Pbo+B+R arms, and AEs of clinical interest were:

• atrial fibrillation: 3.7% vs 1.7%;
• hypertension: 5.4% vs 8.4%;
• major bleeding: 2% vs 3.4%; and
• infections: 41.1% vs 34%, respectively.

The ECHO trial results suggest that addition of A to B+R could improve outcomes for older patients with newly diagnosed MCL when given as a frontline therapy.