In a major international study led by researchers at The University of Texas MD Anderson Cancer Center, the targeted therapy ibrutinib continues to show remarkable promise for the treatment of relapsed or refractory mantle cell lymphoma (MCL).
The most recent interim findings of the 18-center Phase 2 study were published today in the New England Journal of Medicine. Previous interim findings were presented in December 2012 at the 54th American Society of Hematology Annual Meeting and Exposition.
Unprecedented results, fewer side effects
"This oral inhibitor of the Bruton's tyrosine kinase in the B-cell receptor pathway is the most important breakthrough to date in the treatment of mantle cell lymphoma," said Michael Wang, M.D., associate professor in MD Anderson's Departments of Lymphoma and Myeloma and Stem Cell Transplantation and Cellular Therapy. Wang is lead author of the trial.
"It is an oral drug, taken once a day, and its side effects are not severe. Yet it can achieve more than previous combination chemotherapy approaches. Our results constitute excellent news for our patients and patients around the world."
The ongoing trial of oral ibrutinib in patients with heavily treated relapsed or refractory MCL has maintained a response rate as high as 70 percent - better than any other single agent ever tested in the challenging disease – with milder side effects than other treatments.
Targeted approach to dangerous disease
MCL is a rare and aggressive B-cell subtype of non-Hodgkin lymphoma that, according to the Leukemia and Lymphoma Society, accounts for 6 percent of non-Hodgkin cases. Despite high response rates to initial highly toxic combination-drug chemotherapy, patients often relapse.The B-cell receptor pathway is critical in B-cell lymphoma, and Bruton's tyrosine kinase (BTK) is an essential component of this pathway. Ibrutinib targets the BTK molecule, causing cell death and decreasing cellular migration and adhesion in malignant B-cells.
Seventy-seven percent had stage 4 disease, and the median number of prior treatments was three.
Ongoing results continue to show promise
In the past six months, ibrutinib has continued to show excellent results. With a median follow-up period of 15 months:Overall response rate was 68 percent
Wang believes further investigation of ibrutinib as a first line therapy and in combination with other targeted therapies and traditional cytotoxic agents is essential.
"This drug, which is the safest option we have for MCL, shows unprecedented durable single agent activity," he said. "The favorable toxicity profile also implies that ibrutinib provides the opportunity for less intense and more effective regimens. The long-term impact of ibrutinib definitely warrants further clinical testing."
Pharmacyclics, Inc., which developed ibrutinib, sponsored the clinical trial.
Wang's co-authors at MD Anderson include Jorge E. Romaguera, M.D., Liang Zhang, M.D., Ph.D., Kate Newberry, Ph.D., and Zhishuo Ou, M.D., Department of Lymphoma and Myeloma; Lei Li, Ph.D., Department of Experimental Radiation Oncology; and Bingliang Fang, Ph.D., Department of Thoracic and Cardiovascular Surgery.
Other members of the research team include Simon Rule, M.D., Derriford Hospital, Plymouth, United Kingdom; Peter Martin, M.D., Weill Cornell Medical College, New York, New York; Andre Goy, M.D., John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ; Rebecca Auer, M.D., Ph.D., Barts Health NHS Trust, London, United Kingdom; Brad S. Kahl, M.D., University of Wisconsin, Madison; Wojciech Jurczak, M.D., Ph.D., Jagiellonian University, Krakow, Poland; Ranjana Advani, M.D., Stanford University Medical Center, Stanford, California; Michael E. Williams M.D., University of Virginia School of Medicine, Charlottesville, Virginia; Jacqueline Barrientos, M.D., Department of Medicine, Hofstra North Shore-LIJ, New Hyde Park, New York; Ewa Chmielowska, M.D., Oddzial Kliniczny Onkologii Centrum Onkologii, Bydgoszcz, Poland; John Radford, M.D., The Christie NHS Foundation Trust and the University of Manchester, Manchester, United Kingdom; Stephan Stilgenbauer, M.D., Universitatsklinikum Ulm, Klinik fur Innere Medizin II, Ulm, Germany; Martin Dreyling, M.D., Klinikum der Universitat Munchen – Campus Grosshadern, Munich, Germany; Wieslaw Wiktor Jedrzejczak, M.D., Medical University of Warsaw, Poland; Peter Johnson, M.D., Cancer Research UK Centre, University of Southampton, United Kingdom; Stephen E. Spurgeon, M.D., Oregon Health and Science University, Portland, Oregon; Nancy Cheng, M.S., Baylor College of Medicine, Houston, Texas; Jesse McGreivy, M.D., Fong Clow, Sc.D., Joseph Buggy, Ph.D., Betty Chang, Ph.D., Darrin Beaupre, M.D., Ph.D. and Lori A. Kunkel, M.D., Pharmacyclics, Inc., Sunnyvale, CA; and Kristie Blum, M.D., Ohio State University Comprehensive Cancer Center, Columbus, Ohio.
Laura Sussman | EurekAlert!
Usher syndrome: Gene therapy restores hearing and balance
25.09.2017 | Institut Pasteur
MRI contrast agent locates and distinguishes aggressive from slow-growing breast cancer
25.09.2017 | Case Western Reserve University
At the productronica trade fair in Munich this November, the Fraunhofer Institute for Laser Technology ILT will be presenting Laser-Based Tape-Automated Bonding, LaserTAB for short. The experts from Aachen will be demonstrating how new battery cells and power electronics can be micro-welded more efficiently and precisely than ever before thanks to new optics and robot support.
Fraunhofer ILT from Aachen relies on a clever combination of robotics and a laser scanner with new optics as well as process monitoring, which it has developed...
Plants and algae use the enzyme Rubisco to fix carbon dioxide, removing it from the atmosphere and converting it into biomass. Algae have figured out a way to increase the efficiency of carbon fixation. They gather most of their Rubisco into a ball-shaped microcompartment called the pyrenoid, which they flood with a high local concentration of carbon dioxide. A team of scientists at Princeton University, the Carnegie Institution for Science, Stanford University and the Max Plank Institute of Biochemistry have unravelled the mysteries of how the pyrenoid is assembled. These insights can help to engineer crops that remove more carbon dioxide from the atmosphere while producing more food.
A warming planet
Our brains house extremely complex neuronal circuits, whose detailed structures are still largely unknown. This is especially true for the so-called cerebral cortex of mammals, where among other things vision, thoughts or spatial orientation are being computed. Here the rules by which nerve cells are connected to each other are only partly understood. A team of scientists around Moritz Helmstaedter at the Frankfiurt Max Planck Institute for Brain Research and Helene Schmidt (Humboldt University in Berlin) have now discovered a surprisingly precise nerve cell connectivity pattern in the part of the cerebral cortex that is responsible for orienting the individual animal or human in space.
The researchers report online in Nature (Schmidt et al., 2017. Axonal synapse sorting in medial entorhinal cortex, DOI: 10.1038/nature24005) that synapses in...
Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...
Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!
When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...
19.09.2017 | Event News
12.09.2017 | Event News
06.09.2017 | Event News
25.09.2017 | Power and Electrical Engineering
25.09.2017 | Health and Medicine
25.09.2017 | Physics and Astronomy