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Following the ECHO trial, are you routinely incorporating acalabrutinib plus bendamustine-rituximab into your frontline treatment approach for patients with MCL?

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What is your preferred frontline treatment approach for generally fit patients with newly dx MCL?

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3 Answers
Mednet Member
Mednet Member
Medical Oncology · IHA Hem Onc Consult
Answered on

This is a question with multiple correct answers. I use the following principles in making my decision:

  • BR is an excellent “backbone” induction regimen in any age group.
  • Cytarabine is the main drug in the more aggressive induction regimens used in younger patients.
  • Induction chemotherapy achieves h...

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Mednet Member
Mednet Member
Hematology · Fred Hutch Cancer Center
Answered on

Yes, but usually for higher risk patients (MIPI and/or Ki67, mTP53), since the increased infectious toxicity in ECHO — while related COVID-era study conduct — has to be considered, and randomized+ observational data suggest a similar long term overall with sequential BR — BTK on relapse overall.

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Mednet Member
Mednet Member
Medical Oncology · Fox Chase Cancer Center
Answered on

I routinely discuss the combination of BR+ acalabrutinib for my patients with TP53 WT disease, but am upfront that it is not a "once size fits all" approach. I discuss that we are clearly seeing a progression free benefit of adding acala to BR, but we don't actually know at this time if giving them ...

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