In light of the TRIANGLE data at ASH, how should we now approach a transplant-eligible patient with a new diagnosis of aggressive mantle cell lymphoma?

The TRIANGLE data presented by Dr. Dreyling on behalf of the European Mantle Cell Network are certainly provocative. Adding ibrutinib to induction pre-BEAM and maintenance post-BEAM (A+I) led to improved FFS compared to standard-of-care induction and maintenance (A). Not surprising, and doesn't tell us yet whether such an approach would be superior to standard of care and then using BTKi at relapse. The more provocative comparison was SOC with BEAM auto (A) vs. ibrutinib + chemo induction and ib...

The TRIANGLE study was a monumental trial led by the European MCL network. The study evaluated three arms R-CHOP/R-DHAP followed by ASCT, R-CHOP/R-DHAP + Ibrutinib (I) followed by ASCT + I (2 years), and R-CHOP/R-DHAP + I followed by I (2 years).

The study demonstrated that the I-containing arms had improved FFS and OS as compared to the SOC arm. Thus demonstrating a benefit to incorporating I in frontline MCL patients who are eligible for ASCT. This does differ from the SHINE study which was co...