Document Type
Article
Publication Date
7-16-2022
Abstract
Ibrutinib is effective in the treatment of relapsed/refractory (R/R) marginal zone lymphoma (MZL) with an overall response rate (ORR) of 48%. However, factors associated with response (or lack thereof) to ibrutinib in R/R MZL in clinical practice are largely unknown. To answer this question, we performed a multicenter (25 US centers) cohort study and divided the study population into three groups: "ibrutinib responders"-patients who achieved complete or partial response (CR/PR) to ibrutinib; "stable disease (SD)"; and "primary progressors (PP)"-patients with progression of disease as their best response to ibrutinib. One hundred and nineteen patients met the eligibility criteria with 58%/17% ORR/CR, 29% with SD, and 13% with PP. The median PFS and OS were 29 and 71.4 months, respectively, with no difference in PFS or OS based on the ibrutinib line of therapy or type of therapy before ibrutinib. Patients with complex cytogenetics had an inferior PFS (HR = 3.08, 95% CI 1.23-7.67, p = 0.02), while those with both complex cytogenetics (HR = 3.00, 95% CI 1.03-8.68, p = 0.04) and PP (HR = 13.94, 95% CI 5.17-37.62, p < 0.001) had inferior OS. Only primary refractory disease to first-line therapy predicted a higher probability of PP to ibrutinib (RR = 3.77, 95% CI 1.15-12.33, p = 0.03). In this largest study to date evaluating outcomes of R/R MZL treated with ibrutinib, we show that patients with primary refractory disease and those with PP on ibrutinib are very high-risk subsets and need to be prioritized for experimental therapies.
Recommended Citation
Epperla, Narendranath; Zhao, Qiuhong; Chowdhury, Sayan Mullick; Shea, Lauren; Moyo, Tamara K; Reddy, Nishitha; Sheets, Julia; Weiner, David M; Geethakumari, Praveen Ramakrishnan; Kandarpa, Malathi; Bruno, Ximena Jordan; Thomas, Colin; Churnetski, Michael C; Hsu, Andrew; Zurbriggen, Luke; Tan, Cherie; Lindsey, Kathryn; Maakaron, Joseph; Caimi, Paolo F; Torka, Pallawi; Bello, Celeste; Ayyappan, Sabarish; Karmali, Reem; Kim, Seo-Hyun; Kress, Anna; Kothari, Shalin; Sawalha, Yazeed; Christian, Beth; David, Kevin A; Greenwell, Irl Brian; Janakiram, Murali; Kenkre, Vaishalee P; Olszewski, Adam J; Cohen, Jonathon B; Palmisiano, Neil D.; Umyarova, Elvira; Wilcox, Ryan A; Awan, Farrukh T; Alderuccio, Juan Pablo; Barta, Stefan K; Grover, Natalie S; Ghosh, Nilanjan; Bartlett, Nancy L; Herrera, Alex F; and Shouse, Geoffrey, "Predictive Factors and Outcomes for Ibrutinib in Relapsed/refractory Marginal Zone Lymphoma: A multicenter Cohort Study" (2022). Department of Medicine Faculty Papers. Paper 365.
https://jdc.jefferson.edu/medfp/365
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
PubMed ID
35842643
Language
English
Comments
This article is the author’s final published version in Journal of Hematology and Oncology, Volume 15, Issue 1, December 2022, Article number 96.
The published version is available at https://doi.org/10.1186/s13045-022-01316-1. Copyright © Epperla et al.