Andre Goy, MD, MS, chief, Division of Lymphoma, chairman and director, John Theurer Cancer Center, discusses challenges in the treatment of patients with mantle cell lymphoma.
Andre Goy, MD, MS, chief, Division of Lymphoma, chairman and director, John Theurer Cancer Center, discusses challenges in the treatment of patients with mantle cell lymphoma (MCL).
Despite recent success in the treatment of these patients—particularly in the relapsed/refractory setting—there are still several challenges in the treatment of MCL, Goy says. One of the biggest obstacles is that the median age of diagnosis is in the mid- to late-60s, which makes it particularly difficult for physicians to administer intensive therapy. In addition, investigators still do not know if high-dose transplant is beneficial after induction therapy—especially in patients who are minimal residual disease-negative.
Achieving a durable complete response early in treatment is critical in patients with MCL, Goy adds. This is being investigated further in the French TRIANGLE study, which is replacing stem cell transplant with ibrutinib (Imbruvica) maintenance following standard induction therapy. The third challenge for research is in the patients who present with blastoid variant, highly proliferative disease, and p53 mutations. These patients typically do poorly, but the ZUMA-2 trial has shown promising early data with treating this population with chimeric antigen receptor T-cell therapy.