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Expert Highlights Novel Combos, Potential of Immunotherapy in MCL

Gina Columbus @ginacolumbusonc
Published: Tuesday, Apr 25, 2017

Stephen M. Ansell, MD, PhD

Stephen M. Ansell, MD, PhD

Emerging regimens are being tested in several ongoing trials in mantle cell lymphoma (MCL), according to Stephen M. Ansell, MD, PhD.

, Ansell, professor of medicine at Mayo Clinic, discusses emerging combinations being investigated in patients with MCL, the possible role of immunotherapy, and challenges oncologists are still struggling with in this population.

OncLive: What are some the most exciting recent advancements in MCL, and what can we expect coming soon?

Ansell: MCL is a disease that is moving and changing rapidly. Some of the things that we have used that have been our past dogma are now being challenged by new and exciting combinations and therapies. In the past, we really kind of took the view that there were patients who were young and healthy, and older patients who were not. We could move into an approach that was highly aggressive in the younger patients—considering transplantation and the like—and more palliative and less aggressive in elderly patients. 

However, new agents—many of them targeted therapies, such as lenalidomide and ibrutinib—in combination with antibodies have really resulted in excellent results. As we look to the future, we are going to see some of these new combinations being tested against some of the standard therapies. In the future, our approach to MCL will change entirely with a much more sophisticated and nuanced treatment, rather than a very aggressive, [nonpersonalized] approach.

Can you expand on some of those combinations being studied? 

There have been a number of trials, particularly looking at lenalidomide and rituximab used in frontline therapy for patients with MCL. The exciting part has been that the response rates have been very high in patients with this disease. This has challenged a little bit of our thinking with needing to be very aggressive, when you can get results that are very promising with far less aggressive therapy. That is where the future lies, to compare some of these combination approaches with what we have done in the past.

Could we see immunotherapy making headway in this field? 

We could. The challenge right now is that we have very little data on exactly how well immune checkpoint therapies work in MCL. The trials right in the beginning had very few patients with MCL and there has not really been an MCL-focused trial—to the best of my knowledge—to date. There are lots of trials ongoing, and so I am sure that data will come. But, at this point, we don’t know for a fact whether it is an effective therapy.
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Community Practice Connections™: New Directions in Advanced Cutaneous Squamous Cell Carcinoma: Emerging Evidence of ImmunotherapyAug 13, 20191.5
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