Analysis of efficacy and adverse reactions of zanubrutinib in elderly patients with previously untreated mantle cell lymphoma

Peng Xiaojuan; Cui Jie; Liu Peng

doi:10.3760/j.issn.1673-4777.2024.08.015

Abstract：Objective To explore the effect and adverse events of zanubrutinib first line treatment of elderly patients with previously untreated mantle cell lymphoma(MCL).Methods The clinical data of 13 elderly patients with previously untreated MCL treated with zanubrutinib from August 2020 to July 2022 in Gansu Provincial Cancer Hospital were retrospectively reviewed.Patients were given zanubrutinib for more than 4 cycles(1 month as a cycle),and the initial dose was 160 mg twice daily.The objective response rate(ORR),progression free survival(PFS),overall survival(OS),6-month and 12-month PFS rate and OS rate were recorded,and the effects of different factors on PFS and OS were analyzed.Results Follow-up until November 1,2022,among the 13 patients,7 cases achieved completely response(53.8％),2 cases achieved partially response(15.4％)and 4 cases achieved progressive disease(30.8％).The ORR was 69.2％(9/13).The median PFS was 8(4-28)months,and the median OS was 10(5-28)months.The 6-month PFS rate and the OS rate were 68.0％and 92.0％.The 12 month PFS rate and the OS rate were 23.0％and 31.0％.Univariate analysis showed that the Eastern Cooperative Oncology Group score,Ki-67 index and lactic dehydrogenase(LDH)were the probable effect factors for PFS,the age,Ki-67 index and LDH were the probable effect factors for OS(all P＜0.05).However,no statistically significant factors affecting PFS and OS were observed in the multivariate Cox regression analysis results(all P＞0.05).Among the 13 patients,one patient with hematological toxicity was mild,while four patients with non hematological toxicity included infection,secondary malignant tumors,joint pain,and nausea.All adverse reactions were safe and controllable after reduction,discontinuation of zanubrutinib,and symptomatic treatment,with no treatment-related deaths.Conclusions Zanubrutinib first line monotherapy had higher ORR,completely response rates and better tolerance in elderly patients with previously untreated MCL.Especially for patients with poor physical status can not tolerate chemotherapy and personal willingness to refuse chemotherapy.