Dr. Rule on Treatment Approaches for Patients With p53-Mutated MCL

Simon Rule, MD, PhD

Simon Rule, MD, PhD, professor of hematology, Plymouth University Medical School, United Kingdom, discusses treatment approaches for patients with p53-mutated mantle cell lymphoma (MCL).

Patients with MCL who harbor p53 mutations have a poor prognosis, explains Rule. However, the combination of ibrutinib (Imbruvica) and venetoclax (Venclexta) seems to work well in these patients in the relapsed/refractory setting. This knowledge is based on a paper titled “Ibrutinib plus Venetoclax for the Treatment of Mantle-Cell Lymphoma” published by Constantine S. Tam, MD, of the Peter MacCallum Cancer Centre, in the New England Journal of Medicine. Results showed that 50% of patients with a p53 mutation had a complete response with the combination, says Rule.

Although p53 mutations can be identified through genomic sequencing, Rule advises against doing the test if there is no treatment strategy to pursue and only confers a poor prognosis. For example, in younger patients, physicians can look at those results and alter their treatment approach accordingly, whereas in older patients, physicians are still unsure of how these results can affect treatment.
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