Acalabrutinib in patients with mantle cell lymphoma subjected to allogeneic hematopoietic cell transplantation. a phase 2 study by the Polish Lymphoma Research Group (PLRG12 trial).

What was studied

This phase 2 trial tested acalabrutinib in relapsed or refractory mantle cell lymphoma. It was used to shrink tumours before a stem cell transplant from a donor. It was also used as maintenance after transplant. People took acalabrutinib 100 mg doses for 3-6 months. Those with a complete or partial response were referred for transplant. Acalabrutinib was restarted 30-90 days after transplant. It was given for 9 months more. The others stayed on it until progression or unacceptable toxicity.

What they found

28 people were included. 16 responded. 14 had a complete response and 2 had a partial response. Some people went on to transplant. Many had grade 3-4 side effects, most often low neutrophils and infections. Some people died from treatment-related toxicity. Infections caused 4 of these deaths. The abstract gives overall and progression-free survival at 2 years.

What it means for patients

The authors say acalabrutinib gives high response rates in relapsed or refractory mantle cell lymphoma. They say it may serve as a bridge to transplant. They say it may also serve as maintenance after transplant. They say infections are the most frequent life-threatening complications.

Why it is not certain yet

Only 28 people took part. This was a single-group trial with no comparison arm. Serious side effects and deaths occurred. The abstract does not give follow-up beyond 2 years. The abstract does not say how this plan compares with other care.

Source

Acalabrutinib in patients with mantle cell lymphoma subjected to allogeneic hematopoietic cell transplantation. a phase 2 study by the Polish Lymphoma Research Group (PLRG12 trial).

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