ASH 2025 | Time to third-line treatment after BR +/- acalabrutinib in previously untreated MCL: ECHO analysis

So, I had four presentations, and I had another presentation on the ECHO clinical trial. The ECHO clinical trial reanalysis regarding the TTNT, basically, time to next treatment tool. So, it’s basically telling you whether concurrent therapy with acala and BR is better than BR followed by acalabrutinib. So in the community, our community doctors are treating mantle cell lymphoma. They usually start BR, bendamustine rituximab with maintenance. And then if the patient relapsed, we give acalabrutinib. So when I presented the Phase III trial, we are not using them separately. We’re using them concurrently together. So bendamustine rituximab with acalabrutinib, we showed such a good result that not only U.S. FDA, but also EMA from Europe approved this new combination therapy, triple therapy in the front line. So people continue to ask, well, Dr Wang, that possibility exists that the sequential therapy is not as bad as the first therapy, maybe superior. Why do I have to use the triple drug together? It has changed our habit. We already feel comfortable. It may add more toxicity. So in order to answer this question, we did this analysis, right? In conclusion, the TTNT basically, if used concurrent therapy, the time to needing third-line therapy is much longer than the time for the sequential therapy. In conclusion, is that according to our clinical trial, post hoc analysis, these people on trial, they’re not real-world. So we have, we’re ready to control the population. Three agents together is better than using two agents together followed by another agent. So there are so many community physicians already adopted the FDA approval and using concurrent triple therapy without sequencing. That’s the right way to do it.

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