There is limited information on the patient characteristics and outcomes of people with mantle cell lymphoma (MCL), or the treatment strategies adopted to their management in the Australian real-world setting. The purpose of this study was to describe the treatment patterns and outcomes of people with MCL who receive treatment under the Australian Pharmaceutical Benefits Scheme (PBS).
This retrospective study included patients who initiated treatment for MCL between 2011/01/01 and 2021/07/31 with data extracted from the 10% PBS dataset. This dataset contains the dispensing records for 10% of the Australian population and captures all publicly funded treatments in Australia. Outcomes of interest were treatment patterns, duration of therapy, time to next treatment (TTNT), and overall survival (OS). The date of the first medication used for MCL was designated as the index date. The Kaplan-Meier (KM) method was used to analyse the duration of therapy, TTNT, and OS. The effects of baseline patient characteristics and comedications were explored with sub-group sensitivity analyses and Cox proportional hazards regression analyses wherever feasible.
There were 152 patients with MCL included. Most patients were male (68%) and >60 years of age (85%). Treatment trends have changed over the last 10 years. In the front-line setting bendamustine-rituximab (B-R) is now the major regimen used whereas previously rituximab was more commonly used in combination with other agents. In the relapsed/refractory (R/R) setting, the Bruton’s tyrosine kinase inhibitor BTKi (ibrutinib) has replaced the use of rituximab monotherapy or rituximab combinations. In the overall cohort, the median TTNT was 18 months (95%CI, 10-32). The median duration of ibrutinib therapy was 6 months (95%CI, 5-20) and 38.20% of patients was continuing treatment at 12 months. Median OS was 92 (95%CI, 72- not reached (NR)), and 84 months (95% CI, 56-NR), in front-line and R/R patients, respectively.
In the Australian setting, MCL treatment patterns have significantly changed since the introduction of novel agents, including BTKis. Median OS in the front-line setting is more than 7 years.
Clinical trial identification
Legal entity responsible for the study
C. Tam: Financial Interests, Personal, Advisory Role: BeiGene; Financial Interests, Personal, Other, Honoraria: AbbVie, Janssen, BeiGene; Financial Interests, Institutional, Research Grant: AbbVie, Janssen, BeiGene. F. Zhao, R. Gauba, B. Tang: Financial Interests, Personal, Full or part-time Employment: BeiGene; Financial Interests, Personal, Stocks/Shares: BeiGene. S. Azam: Financial Interests, Personal, Full or part-time Employment: Prospection; Financial Interests, Institutional, Other, Contulting, Prospection is a consulting service provider: Pharma companies in AU. S.C. Li: Financial Interests, Personal, Advisory Role: BeiGene.