Dr. Goy on Molecular Features of Mantle Cell Lymphoma
Andre Goy, MD, MS
Andre Goy, MD, MS, chief, Division of Lymphoma, chairman and director, John Theurer Cancer Center, discusses the molecular features of mantle cell lymphoma (MCL).
In addition to classifying patients by their age and their fitness for intensive therapy, physicians have to look at other molecular factors such as Ki-67 to determine what a patient’s optimal therapy is. By identifying molecular high-grade features such as p53 and 17p deletion, physicians can gain greater insight into the behavior of that individual patient’s disease. Though p53 is not as common in MCL as it is in chronic lymphocytic leukemia, the marker can be used to understand prognosis.
In addition to p53, physicians should look for the mutated IGHV gene, which can be complemented by a sequencing panel, if need be, explains Goy. He adds that IGHV mutations can be found in approximately 23% to 25% of patients at baseline. If patients have that mutation, they should not receive frontline chemotherapy. Rather, the combination of ibrutinib (Imbruvica) and rituximab (Rituxan) can be given, after which consolidation chemotherapy can be introduced, says Goy.