OBJECTIVES: The SHINE trial (NCT01776840) evaluating I+BR versus BR in 1L for transplant-ineligible patients aged ≥65 years with stage II-IV MCL met its primary endpoint of improved progression-free survival. The discontinuation rates in the I+BR and BR arms were similar (84% and 77% respectively) with more intolerance in the I+BR arm and more progression in the BR arm. Statistically significant clinical trial outcomes are not always clinically meaningful to prescribers, especially in chronic and life-threatening disease states where improved overall survival is not a demonstrated outcome. We conducted qualitative research to understand physicians’ perceptions of SHINE results and impact on future adoption.

METHODS: Two live summits in 2022 convened U.S.-based oncologists to review trial updates. Participants’ perceptions regarding the SHINE trial were collected in real-time using an electronic keypad, and demographic data were collected via a web-based survey. Descriptive statistics were used for analysis.

RESULTS: Eighty-four, primarily community-based (86%), physicians participated. These providers spend 89% of their working time in direct patient care and see approximately 18 patients/day. Most (73%) use 1L BR therapy for patients with MCL. After reviewing the SHINE data, most reported atrial fibrillation (75%) and bleeding (63%) adverse events as most concerning. Three-fourths said they were very (37%) or moderately (41%) likely to incorporate ibrutinib with BR therapy; 22% were not likely. When asked what reasons for discontinuation had greater influence on their treatment decisions, more physicians identified disease progression rates over intolerance rates (56% vs 39%).

CONCLUSIONS: Overall perceptions of the SHINE trial data were positive. Despite similar discontinuation rates in the I+BR and BR arms, physicians favored the I+BR regimen, 78% vs 22%. Second generation BTK inhibitors have demonstrably improved safety and efficacy profiles, and many physicians expressed a desire to see further studies of BTK inhibitors added to the BR therapy backbone as a potential future regimen.