Relapsed/Refractory Mantle Cell Lymphoma: Beyond BTK Inhibitors

Area of Science:

• Hematology
• Oncology
• Immunology

Background:

• Mantle cell lymphoma (MCL) is an aggressive B-cell non-Hodgkin lymphoma (B-NHL) with poor prognoses in relapsed or refractory (R/R) stages.
• Conventional therapies for R/R MCL offer palliation rather than cure, highlighting the need for novel treatment approaches.

Purpose of the Study:

• To review current evidence on treatments for R/R MCL following progression on Bruton's tyrosine kinase inhibitors (BTKi).
• To discuss emerging therapies and sequencing strategies for R/R MCL post-BTKi failure.

Main Methods:

• Literature review of studies evaluating treatments for R/R MCL.
• Analysis of clinical trial data and real-world evidence for therapies used after BTKi failure.

Main Results:

• Bruton's tyrosine kinase inhibitors (BTKi) have improved progression-free survival (PFS) in R/R MCL compared to the pre-BTKi era.
• Despite BTKi efficacy, resistance develops, leading to poor outcomes with a median overall survival (OS) of 6-10 months.
• Chimeric antigen receptor (CAR) T-cell therapy shows promise in patients progressing after BTKi treatment.

Conclusions:

• Treatment of R/R MCL after BTKi failure remains a significant clinical challenge.
• Optimal sequencing and combination of therapies beyond BTKi are under investigation.
• Further research is crucial to establish effective, curative strategies for R/R MCL.