OBJECTIVES Prognosis for relapsed or refractory (R/R) MCL patients with existing treatments is poor; most patients progress within ~4 months. Ibrutinib, an oral once daily Bruton’s tyrosine kinase inhibitor showed durable single agent activity with good response rate in 111 R/R MCL patients and a median progression free survival (PFS) of 13.9 months. Ibrutinib received breakthrough designation and United States Food and Drugs Administration approval for use in MCL patients who received at least one prior therapy (R/R MCL). This indirect analysis aims to compare the efficacy of ibrutinib to available treatments for R/R MCL patients. METHODS A systematic literature review was conducted to identify clinical trials containing treatments of R/R MCL.  Matching adjusted indirect comparison (MAIC), described by Signorovitch et al 2012, was utilized to obtain indirect relative treatment effect for ibrutinib compared to other treatments.  Using individual patient level data (IPD), baseline characteristics of the ibrutinib trial patients were matched with the patients in the published studies to obtain overall response (ORR) and complete response (CR) rates based on balanced population between the ibrutinib and published studies. Kaplan Meir curves for overall survival and PFS of comparators were plotted alongside those of the matched ibrutinib patients. RESULTS Nineteen studies evaluating various treatments were identified. Five trials evaluating bortezomib, BR (bendamustine, rituximab), FCM (fludarabine, cyclophosphamide, mitoxantrone), FCM-R (fludarabine, cyclophosphamide, mitoxantrone, rituximab), and rituximab-hyper-CVAD were considered for matching. Complete matching of the IPD was possible for the bortezomib, FCM and FCM-R studies.  Ibrutinib showed statistically significant better odds of achieving ORR compared to bortezomib (OR 3.62; 95% CI 1.18-11.14) and FCM (OR 3.22; 95% CI 1.01-10.26). CONCLUSIONS The indirect analysis suggests a potential for improved ORR compared to a few relevant treatments in patients with R/R MCL. Phase III comparative confirmatory data with ibrutinib are anticipated in late 2014.