Dr Gruenbaum on Where Alternative Options to BTK Inhibitors Stand in MCL

“[These] are interesting new developments that ultimately will affect almost every disease where we can potentially use CAR T-cell therapy.”

Lore Gruenbaum, PhD, chief scientific officer and senior vice president of Research at Blood Cancer United, discussed treatment options aside from BTK inhibitors for patients with mantle cell lymphoma (MCL) and the role they could play in the treatment paradigm down the line.

Gruenbaum began by asserting that bispecific antibodies will certainly play an eventual role in MCL treatment, whereas the role of CAR T-cell therapies might be different. She noted that there are many efforts currently in CAR T-cell therapy research both in MCL and related fields that will ultimately contribute to interesting treatment developments for patients with this disease. For example, Gruenbaum specifically highlighted in vivo CAR T-cell therapy research in the multiple myeloma setting. Widespread research with CAR T-cell therapies will ultimately affect the way in which this type of therapy will be incorporated into the treatment paradigms for many diseases.

Gruenbaum then discussed other developing treatments like BTK degraders and second-generation BCL-2 inhibitors. Regarding BCL-2 inhibitors, Gruenbaum mentioned that current agents in this class like venetoclax (Venclexta) have drawbacks in terms of toxicities, thus, the development of second-generation BCL-2 inhibitors like sonrotoclax (BGB-11417) will be important to watch. Early sonrotoclax data have demonstrated improvements in tolerability and flexibility in combinations with other therapies, she said.

Gruenbaum concluded by evaluating the different priorities for different subsets of patients with MCL. She first touched on patients with MCL who are considered to have high-risk disease, suggesting that intensifying treatment regimens should be prioritized with these patients. Conversely, she underscored how de-escalating intensity for patients who are older and more frail is another priority for MCL research.

Want to hear more from Dr Gruenbaum? Be sure to check out our most recent conversation with her, where she discusses the direction MCL research is headed, in addition to other critical areas of unmet needs.