Dr. Shah on Challenges in Treating Patients With High-Risk MCL

Bijal D. Shah, MD
Published: Monday, Nov 05, 2018



Bijal D. Shah, MD, associate member, Department of Malignant Hematology, Moffitt Cancer Center, discusses the challenges in treating patients with high-risk mantle cell lymphoma (MCL).

One of the challenges in the paradigm is distinguishing the data that physicians have for various BTK inhibitors, explains Shah. As it stands, physicians have single-agent data on ibrutinib (Imbruvica) and acalabrutinib (Calquence), combination data with ibrutinib and rituximab (Rituxan), and triplet data with ibrutinib, lenalidomide (Revlimid), and rituximab. It is difficult to differentiate the regimens from each other because the data suggest that they demonstrate similar efficacy, says Shah.

Even the addition of venetoclax (Venclexta) does not seem to differentiate one regimen from another for high-risk patients, notes Shah. In patients with proliferative MCL, Shah predicts that these regimens, especially single-agent rituximab or the combination of rituximab and lenalidomide, will not be able to benefit patients. Therefore, physicians will have to carefully consider ways to address this subset.
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Bijal D. Shah, MD, associate member, Department of Malignant Hematology, Moffitt Cancer Center, discusses the challenges in treating patients with high-risk mantle cell lymphoma (MCL).

One of the challenges in the paradigm is distinguishing the data that physicians have for various BTK inhibitors, explains Shah. As it stands, physicians have single-agent data on ibrutinib (Imbruvica) and acalabrutinib (Calquence), combination data with ibrutinib and rituximab (Rituxan), and triplet data with ibrutinib, lenalidomide (Revlimid), and rituximab. It is difficult to differentiate the regimens from each other because the data suggest that they demonstrate similar efficacy, says Shah.

Even the addition of venetoclax (Venclexta) does not seem to differentiate one regimen from another for high-risk patients, notes Shah. In patients with proliferative MCL, Shah predicts that these regimens, especially single-agent rituximab or the combination of rituximab and lenalidomide, will not be able to benefit patients. Therefore, physicians will have to carefully consider ways to address this subset.



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