In a nutshell
This article reviewed current and new treatment options for patients with mantle cell lymphoma.
Some background
Mantle cell lymphoma (MCL) is a rare but aggressive type of non-Hodgkin’s lymphoma. Chemoimmunotherapy is the typical first-line (primary) treatment for MCL. 80 – 90% of patients respond to this treatment. However, many patients eventually relapse or develop refractory (does not respond to treatment) disease.
The goal of MCL therapy is to extend remission while minimizing side effects. Targeted therapies such as ibrutinib (Imbruvica) may help. However, some patients may develop disease that stops responding to ibrutinib. New targeted therapies may help improve outcomes for these patients. Improving treatment strategies for patients with MCL remains challenging.
Methods & findings
The choice of first-line treatment for MCL is based on a patient’s age and fitness. For fit patients under the age of 60, high-dose chemoimmunotherapy followed by a stem cell transplant is recommended. Elderly patients may not be candidates for this treatment approach due to side effects. For these patients, less intense chemoimmunotherapy with or without rituximab (Rituxan) is recommended.
For very low-risk patients, without any symptoms and with normal blood tests, treatment can be delayed. These patients are closely observed for any signs of cancer progression. Studies have shown that for these patients, survival was higher than for those treated immediately after the diagnosis.
For patients who relapse, ibrutinib alone or with other new targeted therapies such as acalabrutinib (Calquence) is a preferred treatment option. In one study, 124 patients received acalabrutinib. 81% of patients responded to treatment. 40% of patients achieved a complete response. The one-year progression-free survival was 62% and the overall survival was 87%.
Newer therapies that remain under investigation for the treatment of MCL include CAR-T cell therapy (immune cells from the patient that are changed in the laboratory to kill cancer cells) and venetoclax (Venclexta), a targeted therapy.
The bottom line
This article reviewed current treatment options for patients with mantle cell lymphoma. Treatments for younger versus older patients and patients who relapse were recommended.
