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ASCO 2025 | The ECHO trial and the approval of acalabrutinib plus bendamustine-rituximab in frontline MCL

Michael Wang, MD, The University of Texas MD Anderson Cancer Center, Houston, TX, comments on the Phase III ECHO trial (NCT02972840), a landmark study that has significantly improved treatment outcomes for older patients with newly diagnosed mantle cell lymphoma (MCL). The trial’s findings showed a substantial increase in progression-free survival (PFS) and a clear trend towards overall survival in the acalabrutinib plus bendamustine and rituximab arm, which has led to FDA approval for front-line treatment in this patient population. This interview took place during the 2025 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.

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Transcript

So the question is about discussing the results of the ECHO trial. I presented the ECHO trial in Madrid, European Hematology Association meeting last year. And it is a very, very exciting study. It has an international study involving 190 centers among many countries. And so the treatment arm is acalabrutinib bendamustine rituximab versus placebo bendamustine rituximab...

So the question is about discussing the results of the ECHO trial. I presented the ECHO trial in Madrid, European Hematology Association meeting last year. And it is a very, very exciting study. It has an international study involving 190 centers among many countries. And so the treatment arm is acalabrutinib bendamustine rituximab versus placebo bendamustine rituximab. It shows that the PFS was significantly higher in the acalabrutinib-BR group versus the placebo group. And this, the PFS was very statistically significant. The overall survival, although was not statistically different, but it was through a clear trend of overall survival towards the acalabrutinib-BR arm. Based on this exciting data, the US FDA has approved this for front-line in older patients. So in older patients, in the past, we treated with R-CHOP therapy. The R-CHOP therapy was standard therapy for many, many years until many studies showed that bendamustine rituximab is much better than R-CHOP therapy. And now we have further, so bendamustine rituximab is the most commonly used standard therapy. And now they have to prove the addition of acalabrutinib. So no longer, the BR is no longer the standard of care. And acalabrutinib plus BR is the current standard care for older patients with newly diagnosed mantle cell lymphoma. I think this is a very exciting time for mantle cell lymphoma patients. The definition of a cure for mantle cell lymphoma is continued remission, complete remission for 15 years. Many, many of my clinical population have achieved CR for over 10 years, sometimes 12 years, 13 years. So I believe that we’re in the process of curing many people in the current time. This is an exciting time for mantle cell lymphoma patients. I wanted to congratulate all the patients and their families.

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