Multinational phase 3 trial of first-line acalabrutinib plus bendamustine-rituximab for mantle cell lymphoma

The multinational phase 3 ECHO trial evaluated addition of acalabrutinib or placebo to first-line bendamustine-rituximab for mantle cell lymphoma (MCL). At median follow-up of 44.9 months, median progression-free survival was 66.4 months in the acalabrutinib group and 49.6 months in the placebo group (HR 0.73; p=0.0160). Benefit was seen across all subgroups, including those with high-risk features. Grade 3 or greater adverse events were reported in 88.9% and 88.2% in the acalabrutinib and placebo groups, respectively. The authors conclude that addition of acalabrutinib to first-line bendamustine-rituximab for MCL significantly improved PFS, with manageable toxicity.