EFS at 24 Months Has Prognostic Potential in MCL

By Kerri Fitzgerald - Last Updated: February 1, 2023

Event-free survival at 24 months (EFS24) may become an important clinical endpoint in mantle cell lymphoma (MCL) in the future, according to researchers investigating its prognostic potential.

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EFS24 is an established endpoint in diffuse large B-cell lymphoma and follicular lymphoma, but its prognostic role in MCL has not been fully understood.

The study, presented at the 10th Annual Meeting of the Society of Hematologic Oncology in Houston, Texas, was led by Yucai Wang, MD, PhD, of the Mayo Clinic in Rochester, Minnesota.

The prospective cohort study covered patients with newly diagnosed MCL from the Iowa/Mayo Lymphoma SPORE MER cohort. Patients were placed in two groups: Era 1 (2002-2009; n=175) and Era 2 (2010-2015; n=168). Investigators measured overall survival (OS) compared to age- and sex-matched general United States population and cause of death.

The results showed that in the more recent era (Era 2), patients who achieved EFS24 had survival approaching the general population. In addition, these patients had a low risk of dying from lymphoma and were more likely to die from other causes.

The patients diagnosed in Era 2 had better OS compared to Era 1, with a five-year OS of 68.4% versus 59.2% (hazard ratio [HR], 0.68; 95% CI, 0.50-0.93). Patients diagnosed in Era 1 who achieved EFS24 (n=98) still had inferior OS compared to the general population, with a standardized mortality

ratio (SMR) of 2.23 (95% CI, 1.67-2.92; P<.001). In contrast, patients diagnosed in Era 2 who achieved EFS24 (n=99) had similar OS compared to the general population, with an SMR of 1.31 (95% CI, 0.78-2.07; P=.31).

For patients who were diagnosed in Era 2 and achieved EFS24, the rate of lymphoma-related death was less than that of lymphoma-unrelated death, with five-year rates of 2.1% and 5.5%, respectively.

“With more efficacious salvage treatment options and likely continued improvement of OS, EFS24 may become an important clinical endpoint in frontline therapy of MCL,” Dr. Wang and colleagues concluded.

Reference

Wang Y, Larson M, Maurer M, et al. Prognostic role of event-free survival at 24 months (EFS24) in newly diagnosed mantle cell lymphoma (MCL). Abstract #MCL-027. Presented at the 2022 Society of Hematologic Oncology (SOHO) Annual Meeting, September 28-October 1, 2022.

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