Journal of Hematology & Oncology (Jul 2022)
Predictive factors and outcomes for ibrutinib in relapsed/refractory marginal zone lymphoma: a multicenter cohort study
- Narendranath Epperla,
- Qiuhong Zhao,
- Sayan Mullick Chowdhury,
- Lauren Shea,
- Tamara K. Moyo,
- Nishitha Reddy,
- Julia Sheets,
- David M. Weiner,
- Praveen Ramakrishnan Geethakumari,
- Malathi Kandarpa,
- Ximena Jordan Bruno,
- Colin Thomas,
- Michael C. Churnetski,
- Andrew Hsu,
- Luke Zurbriggen,
- Cherie Tan,
- Kathryn Lindsey,
- Joseph Maakaron,
- Paolo F. Caimi,
- Pallawi Torka,
- Celeste Bello,
- Sabarish Ayyappan,
- Reem Karmali,
- Seo-Hyun Kim,
- Anna Kress,
- Shalin Kothari,
- Yazeed Sawalha,
- Beth Christian,
- Kevin A. David,
- Irl Brian Greenwell,
- Murali Janakiram,
- Vaishalee P. Kenkre,
- Adam J. Olszewski,
- Jonathon B. Cohen,
- Neil Palmisiano,
- Elvira Umyarova,
- Ryan A. Wilcox,
- Farrukh T. Awan,
- Juan Pablo Alderuccio,
- Stefan K. Barta,
- Natalie S. Grover,
- Nilanjan Ghosh,
- Nancy L. Bartlett,
- Alex F. Herrera,
- Geoffrey Shouse
Affiliations
- Narendranath Epperla
- Division of Hematology, Department of Medicine, The Ohio State University
- Qiuhong Zhao
- Division of Hematology, Department of Medicine, The Ohio State University
- Sayan Mullick Chowdhury
- Division of Hematology, Department of Medicine, The Ohio State University
- Lauren Shea
- Washington University
- Tamara K. Moyo
- Levine Cancer Center, Atrium Health
- Nishitha Reddy
- Vanderbilt University Medical Center
- Julia Sheets
- University of North Carolina
- David M. Weiner
- Perelman School of Medicine at the University of Pennsylvania
- Praveen Ramakrishnan Geethakumari
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center
- Malathi Kandarpa
- Rogel Cancer Center, University of Michigan
- Ximena Jordan Bruno
- University of Vermont
- Colin Thomas
- Thomas Jefferson University
- Michael C. Churnetski
- Winship Cancer Institute, Emory University Medical Center
- Andrew Hsu
- Brown University
- Luke Zurbriggen
- University of Wisconsin
- Cherie Tan
- Cancer Institute of New Jersey
- Kathryn Lindsey
- Medical University of South Carolina
- Joseph Maakaron
- University of Minnesota
- Paolo F. Caimi
- University Hospitals Seidman Cancer Center
- Pallawi Torka
- Roswell Park Cancer Institute
- Celeste Bello
- H. Lee Moffitt Cancer Center and Research Institute
- Sabarish Ayyappan
- University of Iowa
- Reem Karmali
- Northwestern University
- Seo-Hyun Kim
- Rush University
- Anna Kress
- Yale University
- Shalin Kothari
- Yale University
- Yazeed Sawalha
- Division of Hematology, Department of Medicine, The Ohio State University
- Beth Christian
- Division of Hematology, Department of Medicine, The Ohio State University
- Kevin A. David
- Cancer Institute of New Jersey
- Irl Brian Greenwell
- Medical University of South Carolina
- Murali Janakiram
- University of Minnesota
- Vaishalee P. Kenkre
- University of Wisconsin
- Adam J. Olszewski
- Brown University
- Jonathon B. Cohen
- Winship Cancer Institute, Emory University Medical Center
- Neil Palmisiano
- Thomas Jefferson University
- Elvira Umyarova
- University of Vermont
- Ryan A. Wilcox
- Rogel Cancer Center, University of Michigan
- Farrukh T. Awan
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center
- Juan Pablo Alderuccio
- University of Miami
- Stefan K. Barta
- Perelman School of Medicine at the University of Pennsylvania
- Natalie S. Grover
- University of North Carolina
- Nilanjan Ghosh
- Levine Cancer Center, Atrium Health
- Nancy L. Bartlett
- Washington University
- Alex F. Herrera
- City of Hope
- Geoffrey Shouse
- City of Hope
- DOI
- https://doi.org/10.1186/s13045-022-01316-1
- Journal volume & issue
-
Vol. 15,
no. 1
pp. 1 – 6
Abstract
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.
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