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Jeremy S. Abramson, MD, MMSc
Jeremy S. Abramson, MD, MMSc
Posted: Tuesday, February 4, 2025
For patients with mantle cell lymphoma (MCL) experiencing treatment failure, efforts have been dedicated to identifying effective therapeutic options to improve clinical outcomes, according to a study published in Haematologica. Management strategies should be personalized, taking patient preferences and fitness into consideration, explained Brian T. Grainger, BSc, MBChB, FRACP, FRCPA, and Chan Y. Cheah, MBBS, of Sir Charles Gairdner Hospital, Nedlands, Australia, and colleagues.
Despite the increasing resistance rates to covalent Bruton’s tyrosine kinase (BTK) inhibitors, these agents remain the standard of care for patients with MCL. The underlying mechanism behind this resistance is complex and not completely understood. Therefore, identifying patients more susceptible to treatment failure is critical to selecting the most appropriate alternative treatment option as early as possible, Drs. Grainger and Cheah noted. Similarly, allogeneic stem cell transplantation remains the standard of care in young, fit patients with MCL. However, its clinical utility in the general population is limited, given the need for selectivity based on patient fitness, donor availability, and disease kinetics.
The need for additional suitable treatment options has led to the recent approval of the chimeric antigen receptor (CAR) T-cell therapies brexucabtagene autoleucel and liscabatagene maraleucel as well as the noncovalent BTK inhibitor pirtobrutinib. Currently, efforts are focused on evaluating the role of additional therapeutic options for patients with MCL including T-cell–engaging bispecific antibodies, noncovalent BTK inhibitors and BTK degraders, antibody-drug conjugates, and BCL2 inhibitors. In addition, studies have also investigated a combined therapeutic approach with BTK inhibitors and BCL2 inhibitors or BTK inhibitors and CAR T-cell therapy.
Disclosure: For full disclosures of the study authors, visit haematologica.org.
