Non-Hodgkin lymphoma accounts for about 4 percent of all cancer cases in the United States, according to the American Cancer Society. Mantle cell lymphoma (MCL) is a form of non-Hodgkin lymphoma that originates in the “mantle” portion of the lymph nodes, per the Leukemia and Lymphoma Society (PDF). The disease is often diagnosed at a more advanced stage and is often aggressive and hard to treat. It tends to affect people over age 65 who may not be able to tolerate aggressive therapies. The study results demonstrated success at “the highest rate ever in this population and we believe it sets a new benchmark,” said Michael Wang, MD, a professor in the department of lymphoma and myeloma at The University of Texas MD Anderson Cancer Center in Houston, who led the study, at a press briefing at the ASCO conference. The SHINE study tracked 523 people 65 or older who were newly diagnosed with disease and compared two treatment regimens: ibrutinib (Imbruvica) in combination with bendamustine (Bendeka, Belrapzo, Treanda) plus rituximab (Rituxan) for maintenance, versus the standard treatment, bendamustine plus rituximab. The group that received ibrutinib in addition to standard treatment gained two more years of time in which the disease did not progress compared with the group that received standard treatment — 6.7 years versus 4.4 years. What’s more, only half as many people in the ibrutinib group required additional treatment compared with the group that received standard treatment. “This is very meaningful,” said Dr. Wang. The new combination may become the new standard for first-line treatment for older adults with the disease. Queried about whether insurance companies would be willing to cover the cost of this breakthrough drug regimen, Wang said that the definitive findings make it more likely that insurance companies will be willing to defray the costs. Julie R. Gralow, MD, ASCO chief medical officer and executive vice president, praised the SHINE study authors for targeting the elderly, who are “generally underrepresented” in clinical trials. The study results will also appear in the June 2002 edition of The New England Journal of Medicine.
