Dr. LaCasce Discusses the Future of MCL Treatment

Ann S. LaCasce, MD, MMSc
Published: Monday, Apr 22, 2019



Ann S. LaCasce, MD, MMSc, director of Dana-Farber/Partners CancerCare Hematology-Medical Oncology Fellowship Program, institute physician, Dana-Farber Cancer Institute, and associate professor of medicine, Harvard Medical School, discusses the future of mantle cell lymphoma (MCL) treatment.

The biggest challenge that currently exists in the paradigm is the blastoid variant patient population, says LaCasce. Patients who harbor p53 mutations tend to have a very aggressive disease. Once patients on ibrutinib (Imbruvica) discontinue therapy, their disease can accelerate very rapidly. Moreover, patients with p53 mutations most likely don’t benefit from autologous stem cell transplant, so there needs to be better options for this subset.

Moreover, the field of MCL needs more curative options, LaCasce adds. This could include CAR T-cell therapy, which has shown dramatic benefit in other hematologic malignancies. Most patients will likely fail stem cell transplant at some point, so having more trials, more novel immunotherapy treatments, combinations of CAR T-cell therapies, and other approaches are where the field should shift, states LaCasce.
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Ann S. LaCasce, MD, MMSc, director of Dana-Farber/Partners CancerCare Hematology-Medical Oncology Fellowship Program, institute physician, Dana-Farber Cancer Institute, and associate professor of medicine, Harvard Medical School, discusses the future of mantle cell lymphoma (MCL) treatment.

The biggest challenge that currently exists in the paradigm is the blastoid variant patient population, says LaCasce. Patients who harbor p53 mutations tend to have a very aggressive disease. Once patients on ibrutinib (Imbruvica) discontinue therapy, their disease can accelerate very rapidly. Moreover, patients with p53 mutations most likely don’t benefit from autologous stem cell transplant, so there needs to be better options for this subset.

Moreover, the field of MCL needs more curative options, LaCasce adds. This could include CAR T-cell therapy, which has shown dramatic benefit in other hematologic malignancies. Most patients will likely fail stem cell transplant at some point, so having more trials, more novel immunotherapy treatments, combinations of CAR T-cell therapies, and other approaches are where the field should shift, states LaCasce.



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