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Real-world outcomes with ibrutinib in relapsed or refractory mantle cell lymphoma : a Danish population-based study

Trab, Trine ; Chanchiri, Iman ; Al-Mashhadi, Ahmed Ludvigsen ; Dall, Emma Berggren ; Rasch, Stine ; Johansen, Mette ; Husby, Simon ; Simonsen, Mikkel Runason ; Clausen, Michael Roost and Larsen, Thomas Stauffer , et al. (2025) In Blood Neoplasia 2(3).
Abstract

Ibrutinib was approved for relapsed/refractory (R/R) mantle cell lymphoma (MCL) based on high response rates in clinical trials, but it is unclear how effective ibrutinib is in the real-world setting. This study provides population-based response rates and survival estimates and characterization of prognostic indicators and adverse events (AEs) to ibrutinib for patients with R/R MCL. All patients diagnosed with MCL in Denmark from 2010 to 2022 were identified in the Danish Lymphoma Registry and screened for eligibility. Data were collected from health records. Patients receiving ibrutinib in second or later lines were included and followed from ibrutinib start until death or last follow-up. End points were overall response rate (ORR),... (More)

Ibrutinib was approved for relapsed/refractory (R/R) mantle cell lymphoma (MCL) based on high response rates in clinical trials, but it is unclear how effective ibrutinib is in the real-world setting. This study provides population-based response rates and survival estimates and characterization of prognostic indicators and adverse events (AEs) to ibrutinib for patients with R/R MCL. All patients diagnosed with MCL in Denmark from 2010 to 2022 were identified in the Danish Lymphoma Registry and screened for eligibility. Data were collected from health records. Patients receiving ibrutinib in second or later lines were included and followed from ibrutinib start until death or last follow-up. End points were overall response rate (ORR), progression-free survival (PFS), overall survival (OS), frequency of AEs, and AE-related discontinuation and dose reductions. In total, 146 patients were included (median age, 73 years); 90 (62%) received ibrutinib in second line. ORR was 56%, median PFS 5.8 months, and median OS 12.0 months. In Cox regressions, factors associated with inferior PFS were Ki67 of ≥50% (hazard ratio [HR], 2.34; 95% confidence interval [CI], 1.47-3.71), blastoid or pleomorphic subtype (HR, 3.00; 95% CI, 2.04-4.41), early relapses (HR, 1.65; 95% CI, 1.15-2.36), and refractory disease (HR, 1.57; 95% CI, 1.07-2.30). Three-year cumulative incidences of discontinuation and dose reductions owing to AEs were 19% and 22%, respectively. Median OS after ibrutinib discontinuation was 1.9 months. In conclusion, real-world outcomes after initiation of ibrutinib for R/R MCL were poorer than observed in clinical trials, and dose-limiting toxicities were common, emphasizing the need for more effective treatments and dose-optimization studies.

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publishing date
type
Contribution to journal
publication status
published
subject
in
Blood Neoplasia
volume
2
issue
3
article number
100128
publisher
Elsevier
external identifiers
  • pmid:40809191
  • scopus:105012312423
ISSN
2950-3280
DOI
10.1016/j.bneo.2025.100128
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 The American Society of Hematology
id
e21c91df-3384-413c-ae9e-d9adab871aff
date added to LUP
2025-12-12 14:11:36
date last changed
2025-12-13 03:00:12
@article{e21c91df-3384-413c-ae9e-d9adab871aff,
  abstract     = {{<p>Ibrutinib was approved for relapsed/refractory (R/R) mantle cell lymphoma (MCL) based on high response rates in clinical trials, but it is unclear how effective ibrutinib is in the real-world setting. This study provides population-based response rates and survival estimates and characterization of prognostic indicators and adverse events (AEs) to ibrutinib for patients with R/R MCL. All patients diagnosed with MCL in Denmark from 2010 to 2022 were identified in the Danish Lymphoma Registry and screened for eligibility. Data were collected from health records. Patients receiving ibrutinib in second or later lines were included and followed from ibrutinib start until death or last follow-up. End points were overall response rate (ORR), progression-free survival (PFS), overall survival (OS), frequency of AEs, and AE-related discontinuation and dose reductions. In total, 146 patients were included (median age, 73 years); 90 (62%) received ibrutinib in second line. ORR was 56%, median PFS 5.8 months, and median OS 12.0 months. In Cox regressions, factors associated with inferior PFS were Ki67 of ≥50% (hazard ratio [HR], 2.34; 95% confidence interval [CI], 1.47-3.71), blastoid or pleomorphic subtype (HR, 3.00; 95% CI, 2.04-4.41), early relapses (HR, 1.65; 95% CI, 1.15-2.36), and refractory disease (HR, 1.57; 95% CI, 1.07-2.30). Three-year cumulative incidences of discontinuation and dose reductions owing to AEs were 19% and 22%, respectively. Median OS after ibrutinib discontinuation was 1.9 months. In conclusion, real-world outcomes after initiation of ibrutinib for R/R MCL were poorer than observed in clinical trials, and dose-limiting toxicities were common, emphasizing the need for more effective treatments and dose-optimization studies.</p>}},
  author       = {{Trab, Trine and Chanchiri, Iman and Al-Mashhadi, Ahmed Ludvigsen and Dall, Emma Berggren and Rasch, Stine and Johansen, Mette and Husby, Simon and Simonsen, Mikkel Runason and Clausen, Michael Roost and Larsen, Thomas Stauffer and Christensen, Jacob Haaber and Pedersen, Robert Schou and Frederiksen, Mikael and Jerkeman, Mats and Poulsen, Christian Bjørn and Haunstrup, Laura Mors and Brown, Peter and El-Galaly, Tarec Christoffer and Grønbæk, Kirsten}},
  issn         = {{2950-3280}},
  language     = {{eng}},
  number       = {{3}},
  publisher    = {{Elsevier}},
  series       = {{Blood Neoplasia}},
  title        = {{Real-world outcomes with ibrutinib in relapsed or refractory mantle cell lymphoma : a Danish population-based study}},
  url          = {{http://dx.doi.org/10.1016/j.bneo.2025.100128}},
  doi          = {{10.1016/j.bneo.2025.100128}},
  volume       = {{2}},
  year         = {{2025}},
}