Real World Treatment Practices for Mantle Cell Lymphoma in Japan: An Observational Database Research Study (CLIMBER-DBR)

Abstract

Mantle cell lymphoma (MCL) accounts for approximately 3% of all cases of malignant lymphoma in Japan. The CLIMBER-DBR (Treatment practices and patient burden in chronic lymphocytic leukemia and mantle cell lymphoma patients in the real world: An observational database research in Japan) study examined the clinical characteristics, treatment patterns, and healthcare resource utilization of MCL in a real-world clinical setting in Japan. Using the Japanese Medical Data Vision database, we extracted data for 1130 patients with MCL (ICD-10 code C83.1) registered between March 1, 2013 and February 28, 2018. The date of first MCL diagnosis was taken as the index date. The mean (standard deviation) age, body weight, and modified Charlson Comorbidity Index were 71.4 (10.9) years, 58.3 (11.7) kg, and 1.9 (1.6), respectively, and 24.6% were ≤65 years old. The median follow-up period was 654 days (first-third quartile 290.5 E049 days). A total of 802 patients (71.0%) underwent first-line treatment. The most common first-line treatment was bendamustine/rituximab (BR; 27.8%), followed by rituximab/cyclophosphamide/doxorubicin/vincristine/prednisolone (R-CHOP; 15.6%) and rituximab/tetrahydropyranyl-adriamycin/cyclophosphamide/vincristine/prednisolone (R-THP-COP; 6.5%). The median (95% confidence interval) times to initial (first-line), second-line, and third-line treatments were 45 (36 E2), 687 (624 E34), and 1188 (1099 E444) days, respectively. Treatment practices for MCL in Japan are consistent with trends observed in Western countries. Our study can serve as a benchmark to assess future MCL treatments in Japan.

Keywords: Japan; Mantle cell lymphoma; real world; resource utilization; treatment patterns.

Fig. 1

Study population

Fig. 2

Treatment sequence. The top five first-line treatments and the second-/third-line treatments prescribed to ≥2% of patients are shown in color. Inner, middle, and outer rings represent first-line, second-line, and third-line treatments, respectively. The individual treatments are shown in descending order of frequency. B, bendamustine; R, rituximab; CHOP, cyclophosphamide/doxorubicin/vincristine/prednisolone; MEAM, ranimustine/etoposide/cytarabine/melphalan; hyper-CVAD, hyperfractionated cyclophosphamide/vincristine/doxorubicin/dexamethasone; MA, methotrexate/cytarabine; VR-CAP, bortezomib/rituximab/cyclophosphamide/doxorubicin/prednisolone; CHASER, cyclophosphamide/cytarabine/dexamethasone/etoposide/rituximab; ICE, ifosfamide/carboplatin/etoposide

Fig. 3

Kaplan–Meier plots of TIT (a), TFST (b), and TSST (c) in the overall study cohort. TIT was calculated as the time from the index date (date of first MCL diagnosis) to the first prescribed antineoplastic treatment. TFST and TSST were calculated as the time from the first prescription to the prescription of second-line (TFST) or third-line (TSST) treatments. TIT, time to initial (i.e., first-line) treatment; TFST, time to first-subsequent (i.e., second-line) treatment; TSST, time to second-subsequent (i.e., third-line) treatment

Fig. 4

Kaplan–Meier plots of TIT (a), TFST (b), and TSST (c) treatments in patients divided by age at the study index (≤65 or >65 years). TIT was calculated as the time from the index date (date of first MCL diagnosis) to the first prescribed antineoplastic treatment. TFST and TSST were calculated as the time from the first prescription to the prescription of second-line (TFST) or third-line (TSST) treatments. TIT, time to initial (i.e., first-line) treatment; TFST time to first-subsequent (i.e., second-line) treatment; TSST, time to second-subsequent (i.e., third-line) treatment