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Efficacy and safety of ibrutinib in Japanese patients with relapsed or refractory mantle cell lymphoma
Authors:Dai Maruyama  Hirokazu Nagai  Noriko Fukuhara  Toshiyuki Kitano  Takayuki Ishikawa  Hirohiko Shibayama  Ilseung Choi  Kiyohiko Hatake  Toshiki Uchida  Momoko Nishikori  Tomohiro Kinoshita  Yoshihiro Matsuno  Tomoaki Nishikawa  Satoko Takahara  Kensei Tobinai
Affiliation:1. Department of Hematology, National Cancer Center Hospital, Tokyo, Japan;2. Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan;3. Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan;4. Department of Hematology and Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan;5. Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan;6. Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan;7. Department of Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan;8. Department of Hematology Oncology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan;9. Department of Hematology and Oncology, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan;10. Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital, Nagoya, Japan;11. Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan;12. Janssen Pharmaceutical K.K., Tokyo, Japan
Abstract:In this multicenter, single‐arm, phase II study, the efficacy and safety of ibrutinib were examined in Japanese patients with relapsed or refractory mantle cell lymphoma (MCL). Patients (age ≥20 years) with relapsed or refractory MCL who had progressed after receiving at least one prior treatment regimen, were enrolled. Patients were treated with oral ibrutinib (560 mg once daily; 28‐day cycle) until disease progression (or relapse), unacceptable toxicity, or study end. The primary end‐point was overall response rate. Secondary end‐points included duration of response (DOR), time to response, progression‐free survival (PFS), overall survival, and safety. Of the 16 patients who received treatment, 5 patients discontinued the study (progressive disease, 4; sepsis, 1). Median duration of ibrutinib exposure was 6.5 months (range, 2.8–8.3 months). The overall response rate was 87.5% (90% confidence interval, 65.6–97.7; complete response = 2 [12.5%]; partial response = 12 [75.0%]). Median time to response for all responders (n = 14) was 1.8 months (range, 0.7–5.3 months). The median DOR and PFS were not estimable due to censoring (range: DOR, 1.1–6.4+ months; PFS, 2.8–8.0+ months). Overall survival data were immature due to the limited observation period. A total of 8/16 patients (50%) had at least one grade 3 adverse event (AE), and 5 (31.3%) patients reported serious AEs. The most commonly reported AEs were diarrhea and stomatitis (37.5% each), platelet count decrease (31.3%), and anemia (25%). Overall, orally administered single agent ibrutinib was efficacious with an acceptable safety profile in Japanese patients with relapsed or refractory MCL. Clinical trial registration NCT02169180 (ClinicalTrials.gov).
Keywords:Efficacy  ibrutinib  mantle cell lymphoma  overall response rate  safety
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