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TRIANGLE trial: Auto-HSCT in ibrutinib-containing first-line treatment for MCL
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Ibrutinib-containing first-line treatment with or without auto-HSCT has shown efficacy in younger patients with MCL.1 During the 66th ASH Annual Meeting and Exposition, Martin Dreyling presented the long-term results of the TRIANGLE trial (NCT02858258) evaluating the role of auto-HSCT in the treatment of 870 younger patients with MCL.1 Patients were randomized to Arm A (n = 288), Arm A+I (n = 292), and Arm I (n = 290).1 |
| Key learnings |
| At a median follow-up of 55 months, FFS was superior with A+I (82%) vs A (70%) (HR 0.64; p = 0.0026). A vs I (HR, 1.29; p = 0.9890) and A+I vs I (HR, 0.83; p = 0.21) did not demonstrate FFS superiority. |
| Patients receiving A+I with Ki-67 >50% (HR, 0.62), blastoid cytology (HR, 0.57), and p53 >50% (HR, 0.68) showed FFS superiority vs I. |
| 4-year OS was improved with I (90%) and A+I (88%) vs A (81%); A vs I (HR, 0.565; p = 0.0019); A vs A+I (HR, 1.0587; p = 0.0036); and A+I vs I (ongoing). |
| Grade ≥3 blood and lymphatic system disorders (54%) and infections (34%) were high in the A+I arm. |
| These findings suggest that ibrutinib + standard treatment followed by 2-years of ibrutinib maintenance may offer a potential first-line treatment for younger patients with MCL. |
Abbreviations: A, standard treatment + auto-HSCT; A+I, standard treatment + ibrutinib + auto-HSCT; auto-HSCT, autologous hematopoietic stem cell transplantation; FFS, failure-free survival; HR, hazard ratio; I, ibrutinib; MCL, mantle cell lymphoma; OS, overall survival.
- Dreyling M. Oral abstract #240. Role of autologous stem cell transplantation in the context of ibrutinib-containing first-line treatment in younger patients with mantle cell lymphoma: Results from the randomized triangle trial by the European MCL Network. 66th American Society of Hematology (ASH) Annual Meeting and Exposition; Dec 7, 2024; San Deigo, US.
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