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Andre Goy, MD, MS, discusses intensive therapy for the treatment of patients with mantle cell lymphoma (MCL).
Andre Goy, MD, MS, Chairman and Director, Chief of Lymphoma and Director, Clinical and Translational Cancer Research, John Theurer Cancer Center, discusses intensive therapy for the treatment of patients with mantle cell lymphoma (MCL).
Outside of clinical trials, survival for patients with MCL is approximately 3-5 years, with room for improvement. Even in this ‘era of rituximab,’ Goy says, high-dose therapy has shown benefit in terms of duration of response. Earlier and deeper responses among patients with MCL leads to better outcomes, as many patients become resistant to chemotherapy. Younger patients should receive intensive therapy in the frontline setting, if they can tolerate it, to achieve the longest survival.
As the median age of diagnosis with MCL is in the mid- to late-60s, many patients cannot tolerate intensive therapy. Though R-CHOP has become the default therapy, it is often not enough in this disease. If a patient responds to R-CHOP, he/she will typically benefit from maintenance therapy. Bendamustine plus rituximab offers a backbone that is more tolerable and elicits a slightly better progression-free survival.