Evaluating the R-BAC regimen for patients with MCL that stops responding to TKI therapy

This study evaluated the outcomes of the R-BAC (rituximab, bendamustine, cytarabine) regimen for patients with relapsed or unresponsive mantle cell lymphoma (MCL). This study concluded that R-BAC was effective for these patients.

MCL is a rare but aggressive type of non-Hodgkin’s lymphoma (NHL). After initial treatment, some patients eventually have the cancer return (relapse) or stop responding to treatment (refractory). Tyrosine kinase inhibitors (TKI) such as ibrutinib (Imbruvica) are the typical next step. TKI therapy works inside cancer cells and blocks signals needed for tumors to grow.

About 40% of patients progress (cancer grows or spreads) during TKI treatment. Improving treatment strategies for these patients remains challenging. The R-BAC regimen shows promise for patients with MCL that came back after initial treatment. Whether this regimen is effective for patients whose cancer stops responding to TKI therapy is unclear.

This study had 36 patients with MCL that stopped responding to TKI therapy. Most patients (83.3%) had 2 prior lines of treatment. Patients received R-BAC treatment. Patients were followed for an average of 18 months.

Overall, 83% of patients responded to treatment. On average, patients survived for an average of 12.5 months. Patients survived for an average of 10.1 months without cancer growth or spread.

15 patients had cancer growth or spread after R-BAC treatment. Among these patients, the average survival was 2.3 months.

11 patients had a stem cell transplant after R-BAC treatment. Of these, only 1 patient had cancer growth or spread after the transplant. 4 patients continued to have no signs of cancer 1 year later.

This study concluded that R-BAC was effective for patients with MCL that stopped responding to TKI treatment. The authors suggest that this regimen may be recommended for patients who are good candidates for a stem cell transplant.

This study had a very small number of patients and looked back in time to analyze data. More studies are needed to confirm these results.