In a nutshell
This article reviewed new developments in treatments and disease management for mantle cell lymphoma (MCL).
MCL is an aggressive type of non-Hodgkin’s lymphoma. The typical first-line treatment for MCL is chemoimmunotherapy. The most commonly used regimen is R-CHOP. 80 – 90% of patients respond to this treatment. However, many patients eventually relapse or develop unresponsive disease.
The goal of MCL therapy is to extend remission while minimizing side effects. Several new therapies for MCL remain under investigation, including targeted therapy and cellular therapy. Improving treatment strategies for patients with MCL remains challenging.
Methods & findings
Several new treatment combinations are under investigation in clinical studies. In one study, 15 patients received ibrutinib (Imbruvica) plus buparlisib (BKM120). 73% of patients had complete disappearance of all signs of cancer. With manageable side effects, the authors suggest that this combination is promising.
In another study, 20 patients received lenalidomide (Revlimid) plus chemotherapy. Then, patients received maintenance therapy with lenalidomide and rituximab (Rituxan). This is a low-dose treatment given over a long period to prevent relapse. 95% of patients had complete disappearance of all signs of cancer. The authors suggest that this combination is promising.
In another study, patients received either BR (bendamustine, rituximab) or chemotherapy before a stem cell transplant. 5 years after treatment, more patients in the BR group were still alive compared to the chemotherapy group (71% vs. 62%). More patients in the BR group remained disease-free at 5 years compared to the chemotherapy group (71% vs. 62%). The authors suggest that BR is an effective therapy before transplant.
For disease management, surveillance imaging can be used to monitor patient outcomes over the course of treatment. PET or CT scanning is commonly used. In one study, 141 patients received PET or CT scanning over 4.5 years. Of the 801 scans that were collected, only 3% had positive results (cancer present). 92% of the scans were negative. Because this imaging has little survival benefit and exposes patients to unnecessary radiation, the authors suggest that it should not be recommended for patients with MCL.
The bottom line
This article reviewed new developments in treatments and disease management for mantle cell lymphoma. The authors suggest that tailoring therapy for individual patients is becoming a key area of MCL research.
Published By :
Leukemia & lymphoma
Jan 30, 2019
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