Mantle cell lymphoma (MCL) is a B-cell non-Hodgkin lymphoma that primarily affects elderly patients. Due to the age of these patients and associated medical conditions, they are often less able to tolerate chemotherapy regimens. Still those patients who are eligible for chemotherapy frequently relapse, and require further treatment. However, clinicians in the Lymphoma Program at Weill Cornell Medicine recently published results from a clinical trial that combined the non-chemotherapy alternatives of lenalidomide and rituximab as an initial treatment for patients with MCL.
These findings were published online Nov. 4 and in the Nov. 5 print issue of the New England Journal of Medicine. They demonstrate that the combination of lenalidomide and rituximab provides an effective alternative to chemotherapy for MCL patients. Over 90% of patients enrolled in the trial responded to the therapy, with long term outcomes at the 2 year mark remaining steady in 85% of patients. During treatment patients maintained a high quality of life and were able to participate in daily activities like work, travel, and standard social activities.
The lead author of the study Dr. Jia Ruan an associate professor of clinical medicine and a member of the Sandra and Edward Meyer Cancer Center at Weill Cornell Medicine. She commented on the results,
“For patients, their quality of life was preserved or improved, and that’s a huge step up from regular chemotherapy…With this frontline treatment, we were able to achieve a very high quality and durable response rate without needing to use chemotherapy. It’s very meaningful for the patients who have always been told that their disease is without a cure.”
She continued on the benefits of this treatment combination when compared to other treatments,
“Conventional, intensive treatment may be out of reach or undesirable for many MCL patients, who often receive less intensive or palliative care that is of limited benefit. This inspired us to look for a less toxic, biological option with novel drugs that could be easily administered and more widely applicable.”
The senior author of the study Dr. John Leonard, a professor of medicine, the Richard T. Silver Distinguished Professor of Hematology and Medical Oncology at the Joan and Sanford I. Weill Department of Medicine, associate dean for clinical research, and associate director of clinical trials at the Meyer Cancer Center at Weill Cornell Medicine commented on the trial,
“I’m inspired by the fact that patients are enthusiastic about this approach. I’m also excited that lymphoma physicians are thinking out of the box, that many in the community now think that a non-chemotherapy-based paradigm with novel agents is something important to take forward and more broadly assess.”
Clinical trials like this exemplify the bench to bedside approach taken in the Lymphoma Program at Weill Cornell Medicine. Look to this space for future updates on MCL, and treatment with this new combination. A listing of available clinical trials for MCL can be found on our Joint Clinical Trials website.