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Mantle cell lymphoma initial therapy with abbreviated R-CHOP followed by 90Y-ibritumomab tiuxetan: 10-year follow-up of the phase 2 ECOG-ACRIN study E1499

Leukemia volume 31, pages 517–519 (2017)Cite this article

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There is no single accepted treatment approach for mantle cell lymphoma (MCL). Currently, as a general paradigm, young, fit patients receive intensive therapy, usually with high dose chemotherapy and autologous stem cell support consolidation. The more prevalent older or less fit patient often receives less intensive therapy (reviewed in Spurgeon et al.1). R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) has remained a commonly used initial therapy for MCL, yielding high response rates but with limited durability,2 and still serves as a comparator in recently published studies.3, 4, 5 The treatment landscape for MCL when E1499 was designed in the early 2000s often included R-CHOP for six cycles, with consolidative autologous stem cell support in a selected subset of patients, followed by observation. Maintenance rituximab was not generally applied. Given that relatively few MCL patients actually proceed to autologous stem cell support, ECOG-ACRIN designed its earlier trials in MCL to encompass the general MCL population.

The phase 2 E1499 trial, the first MCL trial performed by ECOG-ACRIN, was designed to test the hypothesis that a single dose of radioimmunotherapy (RIT) consolidation with 90Y-ibritumomab tiuxetan after only four cycles of R-CHOP as initial therapy for MCL would be safe, well tolerated and improve time-to-treatment failure (TTF) compared with historical R-CHOP data. E1499 met its primary end point with TTF at 1.5 years of 69% (95% confidence interval: 58–78%)6 and treatment was well tolerated. Here we report 10-year follow-up data on this uniformly treated cohort of patients with MCL.

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Acknowledgements

This study was coordinated by the ECOG-ACRIN Cancer Research Group (Robert L Comis, MD and Mitchell D Schnall, MD, PhD, Group Co-Chairs) and supported in part by Public Health Service Grants CA180794, CA180820, CA180853, CA189859, CA180816, CA180855, CA180799, and from the National Cancer Institute, National Institutes of Health and the Department of Health and Human Services. Its content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute. 90Y-ibritumomab tiuxetan was supplied by Spectrum Pharmaceuticals.

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Author notes

  1. M R Smith

    Present address: 10Current address: Cleveland Clinic Foundation, Cleveland, OH, USA.,

  2. S J Horning

    Present address: 11Current address: Genentech, Inc., South San Francisco, CA, USA.,

  3. B S Kahl

    Present address: 12Current address: Washington University School of Medicine, Saint Louis, MO, USA.,

Authors and Affiliations

  1. Fox Chase Cancer Center, Philadelphia, PA, USA

    M R Smith

  2. Dana-Farber Cancer Institute—ECOG-ACRIN Biostatistics Center, Boston, MA, USA

    F Hong & H Li

  3. Northwestern University, Chicago, IL, USA

    L I Gordon

  4. British Columbia Cancer Agency, Vancouver, BC, USA

    R D Gascoyne

  5. Montefiore Medical Center, Bronx, NY, USA

    E M Paietta

  6. Stanford University, Stanford, CA, USA

    R H Advani

  7. University of Alabama, Birmingham, AL, USA

    A Forero-Torres

  8. Stanford University, Stanford, CA, USA

    S J Horning

  9. University of Wisconsin, Madison, WI, USA

    B S Kahl

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Correspondence to M R Smith.

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Smith, M., Hong, F., Li, H. et al. Mantle cell lymphoma initial therapy with abbreviated R-CHOP followed by 90Y-ibritumomab tiuxetan: 10-year follow-up of the phase 2 ECOG-ACRIN study E1499. Leukemia 31, 517–519 (2017). https://doi.org/10.1038/leu.2016.305

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