Table 2 Chemotherapy-free targeted regimens versus standard chemotherapy in MCL.

Outcomes of chemotherapy-free regimens are shown for both newly diagnosed and relapsed patients with MCL, noting percent of patients with overall response, complete response, and toxicity. Standard chemotherapy is shown at the bottom of the table to primarily compare the toxicity effects on patients. Sources of data are cited in parentheticals, left column.

Newly diagnosed patientsOverall responseComplete responseToxicity (grade ≥ 3)Secondary malignancy
Therapy
Lenalidomide + rituximab (41)92% (n = 36)64% (n = 36)Neutropenia, 50%; rash, 29%;
thrombocytopenia, 13%;
tumor flare, 11%; anemia,
11%
None
Rituximab + ibrutinib (40)100% (n = 50)72% (n = 50)Fatigue, 6%None
Ibrutinib + lenalidomide +
Rituximab (65)
83% (n = 29)41% (n = 29)Neutropenia, 38%; infections,
22%; rash, 14%
None
Relapsed-refractory patients
Ibrutinib + rituximab (38)88% (n = 50)44% (n = 50)Atrial fibrillation, 12%None
Ibrutinib + venetoclax (42)71% (n = 17)67% (n = 16)Only low grade ≤ 3 diarrhea
and fatigue
None
Acalabrutinib81% (n = 100)40% (n = 49)Neutropenia, 10%; anemia,
9%
None
Chemotherapy
Rituximab-hyper-
cyclophosphamide
vincristine adriamycin
dexamathasone (R-Hyper-
CVAD) (10, 72)
96% (n = 97)54% (n = 97)Febrile neutropenia, 73%;
hematotoxicity, >50%
6.2%
Rituximab-cyclophosphamide
hydroxydaunomycin
oncovin prednisone
(R-CHOP)/maxi-CHOP (9)
97% (n = 160)87% (n = 160)Febrile neutropenia, 75%;
hematotoxicity, >50%
9.4%
Rituximab-bendamustine
(R-Benda) (73)
100% (n = 20)95% (n = 20)Thrombocytopenia, 87%;
neutropenia, 29%
6 to 11%