Dr Habermann on the Evolving Treatment Landscape of Mantle Cell Lymphoma

Thomas M. Habermann, MD, consultant, Division of Hematology, Department of Internal Medicine, professor of medicine, Mayo Clinic, member, the Lymphoma Research Foundation’s Scientific Advisory Board, discusses the evolving treatment landscape of mantle cell lymphoma (MCL).

Although ibrutinib (Imbruvica) has been well established as a treatment for patients with relapsed/refractory MCL, the emergence of other BTK inhibitors have provided other options for these patients, Habermann explains. Ongoing randomized clinical trials are evaluating ibrutinib and the other 3 approved BTK inhibitors: acalabrutinib (Calquence), zanubrutinib (Brukinsa), and pirtobrutinib (Jaypirca). In January 2023, the FDA approved pirtobrutinib for the treatment of adult patients with relapsed or refractory MCL following at least 2 lines of systemic therapy, including a BTK inhibitor. The ongoing phase 3 BRUIN-MCL-321 trial (NCT04662255) is evaluating pirtobrutinib vs the other 3 approved BTK inhibitors in patients with MCL who received at least 1 prior line of therapy and have not been treated with a BTK inhibitor.

Additionally, CAR T-cell therapy has earned a role for patients with MCL who have had multiple relapses, Habermann expands. The FDA approved brexucabtagene autoleucel (Tecartus; formerly KTE-X19) as a treatment for adult patients with relapsed/refractory MCL in July 2020.

Moreover, the phase 3 TRIANGLE study (NCT02858258) showed that ibrutinib plus standard chemoimmunotherapy followed by autologous stem cell transplant (ASCT) and 2 years of maintenance ibrutinib significantly improved outcomes vs standard chemoimmunotherapy induction and ASCT alone for younger patients with MCL.