SOHO State of the Art Updates and Next Questions: Managing Relapsed Mantle Cell Lymphoma.

Autor: Romancik JT; Department of Hematology and Medical Oncology; Winship Cancer Institute at Emory University, Atlanta, GA., Gerber DG; Department of Hematology and Medical Oncology; Winship Cancer Institute at Emory University, Atlanta, GA., Zhuang T; Department of Hematology and Medical Oncology; Winship Cancer Institute at Emory University, Atlanta, GA., Cohen JB; Department of Hematology and Medical Oncology; Winship Cancer Institute at Emory University, Atlanta, GA. Electronic address: Jonathon.cohen@emory.edu.
Jazyk: angličtina
Zdroj: Clinical lymphoma, myeloma & leukemia [Clin Lymphoma Myeloma Leuk] 2022 Aug; Vol. 22 (8), pp. 557-565. Date of Electronic Publication: 2022 Jan 11.
DOI: 10.1016/j.clml.2022.01.008
Abstrakt: Mantle cell lymphoma (MCL) is a rare subtype of B-cell non-Hodgkin lymphoma i.e., incurable with current therapies. While some patients experience prolonged remissions following initial therapy, most will have a relapsing-remitting course requiring several lines of treatment over the course of their disease. Several targeted therapies are now available to treat patients with relapsed MCL. The Bruton's tyrosine kinase (BTK) inhibitors, including ibrutinib, acalabrutinib, and zanubrutinib, are highly active in MCL and currently approved for treating patients with relapsed disease. Bortezomib and lenalidomide are available as monotherapy or in combination with other agents. Venetoclax is active and can be considered for use in relapsed MCL, although it is not currently approved by regulatory agencies. Chimeric antigen receptor T-cell (CAR-T) therapy with brexucabtagene autoleucel yields high response rates and is now approved for patients with relapsed MCL. Allogeneic stem cell transplant remains an option for a small subset of medically fit and motivated patients who have progressed through multiple lines of therapy, although its use is limited by substantial toxicity. There is currently no standard approach to sequencing therapies for patients with relapsed MCL, and the ability to utilize disease biologic and clinical characteristics to guide treatment decisions in this setting remains limited. In this review, we summarize the current evidence to guide the management of patients with relapsed MCL, review emerging agents and combination therapies that are under investigation, and outline our current treatment approach for these patients.
(Copyright © 2022. Published by Elsevier Inc.)
Databáze: MEDLINE
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