Zanubrutinib, obinutuzumab, and venetoclax for first-line treatment of mantle cell lymphoma with a TP53 mutation.

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Tác giả: Jeremy S Abramson, Jeffrey A Barnes, Philip Caron, Maria Chabowska, Shalini Chhabra, Ahmet Dogan, Lorenzo Falchi, Clare Grieve, J Erika Haydu, Patrick Connor Johnson, Ashlee Joseph, Hailey E Kelly, Anita Kumar, Alyssa Labarre, Jennifer Kimberly Lue, Rosalba Martignetti, Joanna Mi, Alison Moskowitz, Colette Owens, Sean Plummer, Madeline Puccio, Gilles Salles, Venkatraman Seshan, Elizabeth Simkins, Natalie Slupe, Jacob Soumerai, Andrew D Zelenetz, Honglei Zhang

Ngôn ngữ: eng

Ký hiệu phân loại: 553.453 Tin

Thông tin xuất bản: United States : Blood , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 89450

TP53-mutant mantle cell lymphoma (MCL) is associated with poor survival outcomes with standard chemoimmunotherapy. We conducted a multicenter, phase 2 study of zanubrutinib, obinutuzumab, and venetoclax (BOVen) in untreated patients with MCL with a TP53 mutation. Patients initially received 160 mg zanubrutinib twice daily and obinutuzumab. Obinutuzumab at a dose of 1000 mg was given on cycle 1 day 1, 8, and 15, and on day 1 of cycles 2 to 8. After 2 cycles, venetoclax was added with weekly dose ramp-up to 400 mg daily. After 24 cycles, if patients were in complete remission with undetectable minimal residual disease (uMRD) using an immunosequencing assay, treatment was discontinued. The primary end point was met if ≥11 patients were progression free at 2 years. The study included 25 patients with untreated MCL with a TP53 mutation. The best overall response rate was 96% (24/25) and the complete response rate was 88% (22/25). Frequency of uMRD at a sensitivity level of 1 × 10-5 and uMRD at a sensitivity level of 1 × 10-6 at cycle 13 was 95% (18/19) and 84% (16/19), respectively. With a median follow-up of 28.2 months, the 2-year progression-free, disease-specific, and overall survival were 72%, 91%, and 76%, respectively. Common side effects were generally low grade and included diarrhea (64%), neutropenia (32%), and infusion-related reactions (24%). BOVen was well tolerated and met its primary efficacy end point in TP53-mutant MCL. These data support its use and ongoing evaluation. This trial was registered at www.ClinicalTrials.gov as #NCT03824483.
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