Dr Parrondo on the Current Treatment Landscape of MCL

Ricardo D. Parrondo, MD, hematologist/oncologist, assistant professor, Mayo Clinic, discusses the current treatment landscape of mantle cell lymphoma (MCL) and highlights ongoing areas of investigation in other hematologic malignancies.

The FDA approvals of therapies for patients with MCL, including acalabrutinib (Calquence) and zanubrutinib (Brukinsa), have contributed toward progress in the MCL field. However, it's important to acknowledge that a substantial portion of patients eventually experience disease progression following treatment with these agents, Parrondo begins. The introduction of pirtobrutinib to the MCL treatment paradigm represents the first FDA approval for this agent, he states. Notably, pirtobrutinib has demonstrated effectiveness in patients who have already progressed after receiving covalent BTK inhibitors, making the agent a valuable addition to the MCL arsenal, Parrondo explains. Similar therapeutic advancements extend across other hematologic malignancies as well, including myelofibrosis, polycythemia vera, B-cell non-Hodgkin lymphomas, and diffuse large B-cell lymphoma, he emphasizes. The continuous influx of therapies for these conditions holds promise for improving patient prognosis, Parrondo notes, bringing the treatment armamentarium closer to providing more tailored and effective treatments.

Furthermore, there is renewed attention toward developing next-generation BTK inhibitors and immunotherapies while striving to enhance the production and persistence of CAR T-cell therapy, he expands. This research is expected to usher in significant advancements in CAR T-cell therapy by accelerating the manufacturing process and extending the durability of CAR T-cell treatments. Simultaneously, the exploration of next-generation bispecific antibodies raises intriguing questions about the optimal sequencing of these agents and how to best integrate them into treatment regimens, Parrondo explains.

Taken together, these developments represent a dynamic and promising era in the field of hematologic malignancies. The continuous evolution of therapeutic options, the innovation in small molecule inhibitors, and the ongoing pursuit of next-generation immunotherapies and targeted treatments are collectively contributing to an exciting outlook for patients with these conditions, he concludes.