Rituximab Maintenance Added to Ibrutinib-Containing Therapy in Younger, Untreated Patients With Mantle Cell Lymphoma: Results From the TRIANGLE Trial

A secondary analysis of the TRIANGLE trial indicates that adding rituximab maintenance to ibrutinib-containing therapy prolongs progression-free survival in younger, previously untreated patients with mantle cell lymphoma: the 4-year progression-free survival probability was 85% versus 73% in the arm without autologous stem-cell transplantation (p = 0.003) and 90% versus 75% in the arm with transplantation (p < 0.001). The cost is infection: grade 3 to 5 infectious toxicity occurred in 34% versus 11% and in 41% versus 18% of patients respectively. An important methodological caveat: maintenance was not allocated by randomisation but given according to national and centre practice (61% and 64% of induction responders received it), and the groups were compared using inverse probability of treatment weighting; differences in overall survival remained at the level of a trend.