Results of the TRIANGLE Study for Mantle Cell Lymphoma

Martin Dreyling, MD, Ludwig Maximilian University of Munich, discusses results of the TRIANGLE study testing the addition of ibrutinib to treat mantle cell lymphoma.

Mantle cell lymphoma is a rare form of malignant non-Hodgkin lymphoma affecting B lymphocytes in the lymph nodes in a region called the “mantle zone''. Common symptoms include tumors near the lymph nodes, fever, involuntary weight loss, and night sweats.

The TRIANGLE clinical trial was a randomized, open-label, three-arm study evaluating the addition of ibrutinib to standard treatment with autologous stem cell transplantation (ASCT). Ibrutinib is an oral, covalent BTK inhibitor that disrupts B cell processes. The results of the study were presented at ASH 2024.

The primary outcome of the TRIANGLE study was failure-free survival (FFS). Secondary outcomes included overall survival (OS). 870 patients were randomized into three arms: Arm A, those on standard treatment; Arm A+I, those on standard treatment with addition of ibrutinib with ASCT; and Arm I, those on ibrutinib treatment without ASCT.

At a median follow-up time of 53 months, Arm A+I and Arm A did not show better FFS over Arm I. However, a 5% significance level was seen with FFS-superiority of Arm I over Arm A and FFS-superiority of Arm A+I over Arm A was at 86% (A+I) and 75% (A) FFS. Additionally, when compared to Arm A, OS was prolonged in arms A+I (three year OS of 90%) and I (91%).

Chapters:
Introduction 00:00
Current Management 1:08
TRIANGLE Clinical Trial 2:02
Key Message 4:46