Interactive Case Study

Patient 71 Y/O Diagnosed With MCL

Interactive Case Study

Patient 71 Y/O Diagnosed With MCL

Let’s meet our patient

Patient

Male, 71 years old
Diagnosed with MCL, stage IVA

Comorbidities:

  • Renal impairment
  • OSAS (treated with CPAP)
  • Squamous cell skin cancer (resolved with surgery 4 years prior to diagnosis)

This material has been developed and funded by Gilead Sciences. This case study is intended for healthcare providers only. Adapted patient case from Dr Gloria Iacoboni. This patient was based and treated in Spain.
DLBCL, diffuse large B-cell lymphoma; HCP, healthcare professional; PI, prescribing information; SmPC, summary of product characteristics.
This medicinal product is subject to additional monitoring. This will allow quick identification of new safety information. Healthcare professionals are asked to report any suspected adverse reactions.

What is your first choice for 1L treatment?

R-CHOP
R-CHOP/R-DHAP & ASCT
Hyper-CVAD
Bendamustine + Rituximab

R-CHOP rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone
R-CHOP/R-DHAP (Rituximab + Cyclophos­phamide + Doxo­rubicin + Vincristine + Prednisone + Dexameth­asone + Cytarabine + Cisplatin
Hyper-CVAD (cyclophosphamide, vincristine, doxorubicin, and dexamethasone)

In this case study

1L and 2L treatment and subsequent observations

1L, first-line; 2L, second-line; 18F, fluorine-18; ASCT, autologous haematopoietic stem-cell transplant; CD, cluster of differentiation; ECOG PS, Eastern Cooperative Oncology Group performance status; FDG, fludeoxyglucose; PET, positron emission tomography; R-CHOP, rituximab + cyclophosphamide + doxorubicin hydrochloride + vincristine + prednisone; R-DHAP, rituximab + dexamethasone + cytarabine + cisplatin; TP53, tumour protein 53.

What is your choice for further treatment?

CAR-T
Lenalidomide + Rituximab
DHA+Platinum+Rituximab
Other BTKis

R-CHOP rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone
DHA (dexamethasone, cytarabine) + platinum (carboplatin, cisplatin, or oxaliplatin) + rituximab

In this case study

was chosen as 3L treatment

for this patient due to high risk following progression on ibrutinib

Treatment Timeline: Tecartus®

Adverse events during hospitalisation following Tecartus®

Patients with a history of or active CNS disorder or inadequate renal, hepatic, pulmonary or cardiac function are likely to be more vulnerable to the consequences of the adverse reactions to Tecartus®  and require special attention. Tecartus® is recommended to be infused 3 to 14 days after completion of the lymphodepleting chemotherapy for MCL patients.
3L, third-line; CNS, central nervous system; FluCy, fludarabine and cyclophosphamide; MCL, mantle cell lymphoma.
*Grade 1 CRS requires symptomatic treatment only. If no improvement is observed after 24 hours, tocilizumab 8 mg/kg should be administered intravenously over 1 hour (not to exceed 800 mg). CRS, cytokine release syndrome; h, hour; ICANS, immune effector cell-associated neurotoxicity syndrome.

Treatment outcomes

18F-FDG PET-CT
prior to Tecartus® infusion

18F-FDG PET-CT
1 monthe post to Tecartus® infusion

The patient achieved​

Complete Response

Bone marrow and spleen involvement resolved

Duration of response:

42

MONTHS

Take-home messages

Complete response was achieved (bone marrow and spleen involvement resolved shown here) and has been ongoing for 3.5 years
The patient experienced grade 2 CRS and ICANS, and neutropenia. and neutropenia. These AEs were managed as per institutional protocols
This case presented various challenges, notably the patient’s advanced age (71 years at diagnosis) and multiple comorbidities
18F, fluorine-18; CT, computed tomography; DOR, duration of response; FDG, fludeoxyglucose; PET, positron emission tomography. This is a case presentation. Individual results will vary. Patients with a history of or active CNS disorder or inadequate renal, hepatic, pulmonary or cardiac function are likely to be more vulnerable to the consequences of the adverse reactions to Tecartus® and require special attention. AE, adverse event; CRS, cytokine release syndrome; ICANS, immune effector cell-associated neurotoxicity syndrome.

IL-TEC-0269, FEB 25

Tecartus® is indicated for the treatment of adult patients with relapsed or refractory mantle cell lymphoma (MCL) after two or more lines of systemic therapy including a Bruton’s tyrosine kinase (BTK) inhibitor unless ineligible to BTK inhibitor
Limitation of use: Tecartus® is not indicated for the treatment of patients with active central nervous system lymphoma.
Tecartus® is indicated for the treatment of adult patients with relapsed or refractory B-cell precursor acute lymphoblastic leukaemia (ALL).

The pictures on the website are for illustration purposes (AI generated).

For further information and full list of adverse events, please refer to the approved prescribing information as available at Israeli Ministry of Health website : https://israeldrugs.health.gov.il/#!/byDrug
Report an AE https://www.gileadisrael.co.il/utility/contact
This casestudy is intended for healthcare providers only
For any further questions please contact: medinfo.israel@gilead.com
© Gilead Sciences Israel Ltd. All rights reserved

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