Simon Rule, MD of Plymouth University, Plymouth, UK discusses highlights in mantle cell lymphoma (MCL) from the 2016 American Society of Hematology (ASH) Annual Meeting, held in San Diego, CA. The first presentation Prof. Rule mentions is the follow-up of the Lysa study of younger patients treated with four cycles of R-DHAP, transplant and randomization to rituximab maintenance (NCT00921414). There is a strong progression-free survival (PFS) advantage in favor of the rituximab arm as well as an overall survival (OS) advantage. Further, the Nordic group presented on giving four doses of rituximab after patients become minimal residual disease (MRD) positive. While MRD is only used in clinical trials for now, Prof. Rule believes MRD will affect therapy in future. Further, the first trials of combinations of ibrutinib were presented. In the relapse setting, the Nordic group presented on the PHILEMON trial of lenalidomide, rituximab and ibrutinib (NCT02460276); the combination was well-tolerated with high complete remission (CR) rates. Also, Michael Wang presented his trial on ibrutinib plus rituximab with hyper-CVAD consolidation in newly diagnosed young patients (NCT02427620). It showed that if you use ibrutinib/rituximab frontline, 100% of patient respond and the majority get a CR.
