The ENRICH phase 2/3 randomized trial compared oral ibrutinib plus rituximab against standard immunochemotherapy (R-CHOP or rituximab-bendamustine) as first-line treatment in older mantle cell lymphoma (MCL) patients.
Ibrutinib-rituximab significantly prolonged progression-free survival (PFS) compared to immunochemotherapy, with a 31% reduction in risk of progression or death overall.
The benefit was pronounced for patients initially designated to R-CHOP, with a 63% risk reduction, whereas no significant advantage was observed in those pre-selected for rituximab-bendamustine.
Safety profiles were comparable between arms, with approximately 67% versus 70% experiencing grade 3 or higher adverse events, supporting tolerability of the chemotherapy-free approach.
