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Mantle cell lymphoma is a fast-growing form of lymphoma, a type of blood cancer that affects the lymphatic system. The tissues and organs that produce, store, and carry white blood cells that fight infections and other diseases make up the lymphatic system.
Generally, people 70 years old and younger with a new diagnosis of mantle cell lymphoma will receive a combination of Food and Drug Administration (FDA)-approved drugs. These include chemotherapy treatment along with rituximab. While the chemo drugs work to stop the growth of cancer cells, rituximab enhances the ability of the body’s immune system to destroy the cells. However, there is not one standard treatment approach that is proven to help people with mantle cell lymphoma live longer.
Trial EA4181, led by Nina Wagner-Johnston, MD of Johns Hopkins University, is comparing three different chemotherapy/rituximab treatments to determine which one most effectively treats mantle cell lymphoma in patients ages 70 and younger. The specific treatments are:
- Chemotherapy (bendamustine and cytarabine) plus rituximab
- Chemotherapy (bendamustine and cytarabine) plus rituximab and acalabrutinib
- Bendamustine plus rituximab and acalabrutinib
Treatment one is a usual approach. Treatments two and three include a newer drug called acalabrutinib (uh-KA-luh-BROO-tih-nib). It is a targeted therapy. All of the drugs in this trial, except acalabrutinib, are given through the veins (intravenous). Acalabrutinib comes in the form of capsules, for oral use.
Acalabrutinib is FDA-approved for mantle cell lymphoma that has progressed after at least one prior therapy. Researchers need to find out if the drug is effective as a first treatment in newly diagnosed mantle cell lymphoma patients. To answer this question, Dr. Wagner-Johnson and her colleagues are studying whether adding acalabrutinib to chemo and rituximab will more effectively shrink or stabilize the growth of cancer than the usual approach.
If treatment three proves to be the most effective one, this could be good news for new mantle cell lymphoma patients in one more way. It could end the need for the chemo drug cytarabine, which patients receive in high doses that causes many negative side effects.
Learn more about study EA4181.