Outcomes From the Multicenter ACCRU-LY-1804/CARiBOU TRIAL (Cytarabine, Acalabrutinib and Rituximab Integrated With Bortezomib-Based Outpatient Therapy) in 1st Line Mantle Cell Lymphoma.

What was studied

This was a phase 2 trial in mantle cell lymphoma (MCL) not treated before. It ran in a network of cancer research centers. The regimen is called CARiBOU. It alternated VR-CAP and R-cytarabine, with acalabrutinib given all the time. Treatment ran in 21-day cycles and was given in clinic visits, not in hospital. 41 patients were enrolled. The main goal was the rate of complete metabolic response. The team also tracked safety, stem cell collection and survival. They tested blood for leftover cancer cells.

What they found

39 of the 41 patients responded. 37 had a complete metabolic response. 2 patients who did not respond stopped early because of toxicity. Leftover cancer cells were undetectable in 26 of 33 tested patients. The estimated 18-month progression-free survival and overall survival are given in the abstract. Toxicity was mainly in the blood. 32 patients had a grade 3 blood event. A single grade 3 bleeding event was seen. 4 patients had febrile neutropenia. 6 had serious adverse events. No deaths were related to treatment.

What it means for patients

The authors call CARiBOU an efficient, highly effective outpatient first-line regimen. They say it uses intermediate-dose cytarabine and continuous acalabrutinib. They say it allows flexible choices on later treatment, guided by leftover cancer cells.

Why it is not certain yet

This was a phase 2 trial with no comparison group. It had 41 patients. Leftover cancer cells were tested in 33 patients. Toxicity in the blood was common.

Source

Outcomes From the Multicenter ACCRU-LY-1804/CARiBOU TRIAL (Cytarabine, Acalabrutinib and Rituximab Integrated With Bortezomib-Based Outpatient Therapy) in 1st Line Mantle Cell Lymphoma.

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