Dr Phillips on Important Clinical Trials to Watch in Mantle Cell Lymphoma

“At relapse [following a fixed-duration BTK inhibitor], will these patients be able to be rechallenged with a BTK inhibitor, or will we need to consider other treatment options for these patients?”

Tycel Phillips, MD, an associate professor in the Department of Hematology and Hematopoietic Cell Transplantation in the Division of Lymphoma at City of Hope, discussed important clinical trials and analyses in mantle cell lymphoma (MCL) he is looking out for and what their clinical implications on the field may be.

Phillips began by highlighting the phase 2 TrAVeRse study (NCT05951959), which evaluated acalabrutinib (Calquence) plus venetoclax (Venclexta) and rituximab (Rituxan) in patients with treatment-naive MCL. Phillips pointed out that patient enrollment was completed quickly, and in the study, following induction therapy, patients who achieved a minimal residual disease (MRD)–negative complete response were randomly assigned to maintenance therapy with single-agent acalabrutinib or to observation. Phillips is anticipating seeing what benefits maintenance therapy of the combination provides in this treatment-naive population.

Phillips mentioned how data from the trial reported at the 2025 ASH Annual Meeting and Exposition showed high MRD-negative CR rates at a 10^-5 sensitivity. However, Phillips added that testing for MRD at a 10^-6 sensitivity may be a more appropriate benchmark for MCL.

Phillips then moved into a conversation about the phase 3 TRIANGLE study (NCT02858258) which evaluated ibrutinib (Imbruvica) plus R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) in the frontline setting, followed by 2 years of ibrutinib maintenance. Specifically, Phillips is anticipating additional data on whether patients who relapse after fixed-duration maintenance, which could address whether BTK inhibitor rechallenge is a feasible approach after fixed-duration therapy. Phillips also highlighted the phase 2 BOVen trial (NCT03824483) that evaluated the combination of zanubrutinib (Brukinsa), obinutuzumab (Gazyva), and venetoclax, noting that time to second progression data will also be valuable for this study.