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Published on: September 12, 2025

First-Line Bruton's Tyrosine Kinase Inhibitor-Based Regimens for Mantle Cell Lymphoma

Robert Puckrin1, Diego Villa2,3, Isabelle Fleury4

  • 1Arthur J.E. Child Comprehensive Cancer Centre, University of Calgary, Calgary, AB T2N 5G2, Canada.

Current Oncology (Toronto, Ont.)
|July 27, 2026
PubMed

Insights

Novel covalent Bruton's tyrosine kinase inhibitor (cBTKi) combinations are evolving first-line (1L) therapy for mantle cell lymphoma (MCL). Patient-specific factors beyond traditional criteria guide optimal selection of these advanced cBTKi regimens.

Area of Science:

  • Oncology
  • Hematology
  • Clinical Trials

Background:

  • First-line (1L) therapy for mantle cell lymphoma (MCL) is rapidly advancing.
  • Novel covalent Bruton's tyrosine kinase inhibitor (cBTKi) combinations demonstrate significant activity in recent trials.

Purpose of the Study:

  • To explore the selection of 1L therapy for MCL considering emerging cBTKi options.
  • To analyze the benefits, limitations, and challenges of novel cBTKi regimens in MCL treatment.

Main Methods:

  • Review of recent phase II and phase III clinical trials involving cBTKi combinations.
  • Presentation and discussion of three illustrative patient cases for 1L therapy selection.
  • Analysis of factors influencing treatment decisions, including MCL biology and patient risk tolerance.

Main Results:

  • cBTKi combinations show consistent activity in MCL treatment.
  • Traditional selection criteria may not fully apply to novel cBTKi regimens.
  • Additional factors like MCL biology and patient risk are crucial for therapy selection.

Conclusions:

  • The evolving landscape of MCL therapy requires a multifaceted approach to selecting 1L treatment.
  • Patient-specific factors and emerging cBTKi options necessitate careful consideration for optimal outcomes.
  • Further research is needed to address evidence gaps for these novel regimens.
Keywords:
B-cell lymphoma 2Bruton’s tyrosine kinase inhibitoracalabrutinibchemotherapy-freeibrutinibmantle cell lymphomazanubrutinib

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