Superiority of ibrutinib plus bendamustine and rituximab in newly diagnosed patients with mantle‐cell lymphoma ineligible for intensive therapy: A network meta‐analysis

Abstract

AbstractBecause of lacking of head‐to‐head comparison among recently effective novel agents’ combination regimens for newly diagnosed patients with mantle‐cell lymphoma (MCL) who are ineligible for intensive therapy like autologous stem‐cell transplantation, the optimal option for these patients still remains undefined. We searched relevant published reports. Three randomized controlled trials with 1459 subjects were identified. In the network meta‐analysis, ibrutinib plus bendamustine and rituximab (Ibru + BR) significantly improved progression‐free survival (PFS) when compared to bortezomib, rituximab, cyclophosphamide, doxorubicin, and prednisone (VR‐CAP; hazard ratio [HR]: 0.55, p = .03) and rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R‐CHOP; HR: 0.35, p < .001) for newly diagnosed patients with MCL ineligible for intensive therapy. Among these first‐line treatment regimens (Ibru + BR, VR‐CAP, R‐CHOP, and BR), Ibru + BR had the highest probability of 94.9% to be the best intervention in PFS analysis. No significant difference was found in adverse events analysis. Our data indicated that Ibru + BR seemed to prolong the PFS when compared to VR‐CAP and R‐CHOP for newly diagnosed patients with MCL ineligible for intensive therapy. Considering our limits, prospective clinical trials directly comparing these regimens are warranted.