For eligible patients with mantle cell lymphoma (MCL), consolidative autologous haematopoietic stem cell transplantation (ASCT) is a standard component of frontline therapy but is not universally used owing to resource constraints and tolerability concerns, as well as unclear benefit with improved induction, maintenance and salvage therapies. Now, data from the phase III TRIANGLE trial demonstrate that adding the BTK inhibitor ibrutinib to frontline therapy not only improves outcomes in patients undergoing ASCT, but might also avoid the need for transplantation.

In TRIANGLE, 870 patients ≤65 years of age with stage II–IV MCL were randomly assigned 1:1:1 to receive six alternating cycles of R-CHOP and R-DHAP/DHAOx followed by ASCT (group A), or the same induction immunochemotherapy plus concurrent and maintenance ibrutinib for up to 2 years either with ASCT consolidation (group A + I) or without ASCT (group I). Rituximab maintenance was permitted in all three groups according to national guidelines and was implemented in 58%, 57% and 54% of patients, respectively. The primary end point was failure-free survival (FFS).

对于符合条件的套细胞淋巴瘤（MCL）患者，巩固性自体造血干细胞移植（ASCT）是一线治疗的标准组成部分，但由于资源限制和耐受性问题，以及改善诱导、维持的益处尚不明确，并未得到普遍使用和挽救疗法。现在，来自 III 期 TRIANGLE 试验的数据表明，在一线治疗中添加 BTK 抑制剂伊布替尼不仅可以改善接受 ASCT 的患者的预后，还可能避免移植的需要。

在 TRIANGLE 中，870 名 ≤65 岁的 II-IV 期 MCL 患者按 1:1:1 随机分配，接受六个交替周期的 R-CHOP 和 R-DHAP/DHAOx，然后接受 ASCT（A 组），或相同的诱导免疫化疗加同步和维持依鲁替尼长达 2 年，伴 ASCT 巩固（A + I 组）或不伴 ASCT（I 组）。根据国家指南，所有三组均允许进行利妥昔单抗维持治疗，并分别在 58%、57% 和 54% 的患者中实施。主要终点是无失败生存期（FFS）。