Treating Relapsed Mantle Cell Lymphoma
In the final installment of this 3-part video series, Jonathon Cohen, MD, MS, Assistant Professor, Lymphoma Group, Winship Cancer Institute at Emory University, Atlanta, Georgia, discusses a number of therapies available for the treatment of relapsed mantle cell lymphoma.
Transcript
Mantle cell lymphoma, despite our best efforts and despite improving overall survival, still is very likely to relapse over the lifespan of an individual patient. There are a number of therapies that are currently available for relapsed patients, some of which are FDA approved, and some which are still investigational. I typically use the BTK inhibitor ibrutinib as my first-line therapy in the relapsed setting. This is based in part on the published phase two data which led to its registration, as well as the recent pooled analysis which suggests that receipt of ibrutinib earlier on in the course of treatment may prolong its benefit for an individual patient. There are a number of other options, however, including acalabrutinib, which is a novel BTK inhibitor and which may have decreased side effects compared to ibrutinib, although we still need further follow-up to determine whether this will ultimately be true. Lenalidomide, often combined with rituximab, is a very effective therapy as well. In addition, venetoclax, while still investigational, has shown excellent activity in relapsed mantle cell lymphoma. There are a number of studies ongoing, looking at it alone or in combination with ibrutinib. Finally, there are a number of novel therapies which are being evaluated in combination with ibrutinib and with other agents, including CDK inhibitors, as well as proteasome inhibitors.
