Management of relapsed/refractory mantle cell lymphoma

Leuk Lymphoma. 2024 Aug;65(8):1044-1054. doi: 10.1080/10428194.2024.2338851. Epub 2024 Apr 18.

Abstract

In this review we summarize the current evidence describing the management of patients with relapsed/refractory MCL and outline the various novel therapeutics that have been developed over the past two decades. We also describe how overall response rates, complete response rates, duration of responses, and life expectancy have dramatically increased with the introduction of novel therapies, particularly covalent Bruton Tyrosine Kinase inhibitors (BTKi) and chimeric antigen receptor T-cell (CAR-T) therapy. The most recent emerging options for patients with progressive disease following BTKi or CAR-T, including non-covalent BTKi, antibody-drug conjugates, Bcl-2 inhibitors, and bispecific antibodies, may further improve response rates and outcomes. Future directions should focus on identifying the best sequencing and/or combinations of the increasingly available treatment options while prioritizing strategies with curative potential.

Keywords: BTK; CART; Mantle cell lymphoma; bispecific; refractory; relapse.

Publication types

  • Review

MeSH terms

  • Agammaglobulinaemia Tyrosine Kinase / antagonists & inhibitors
  • Combined Modality Therapy / methods
  • Disease Management*
  • Drug Resistance, Neoplasm*
  • Humans
  • Immunotherapy, Adoptive* / methods
  • Lymphoma, Mantle-Cell* / drug therapy
  • Lymphoma, Mantle-Cell* / pathology
  • Lymphoma, Mantle-Cell* / therapy
  • Molecular Targeted Therapy / methods
  • Neoplasm Recurrence, Local / pathology
  • Protein Kinase Inhibitors* / therapeutic use
  • Treatment Outcome

Substances

  • Protein Kinase Inhibitors
  • Agammaglobulinaemia Tyrosine Kinase