Thomas M. Habermann, MD, Consultant, Department of Hematology, Internal Medicine, Mayo Clinic Professor of Medicine, discusses the evolving treatment landscape for mantle cell lymphoma (MCL).
Ibrutinib (Imbruvica) is a well-established treatment for patients with relapsed/refractory MCL, but the emergence of other BTK inhibitors has given these patients another option, Habermann said. explains. Ongoing randomized clinical trials are evaluating ibrutinib and three other he-BTK inhibitors he acalabrutinib (Calquence), zanubrutinib (Brukinsa), and pirtobrutinib (Jaypirca). January 2023, FDA approves pirtobrutinib for the treatment of adult patients with relapsed or refractory MCL – After at least 2 systemic therapies including a BTK inhibitor. The ongoing phase 3 BRUIN-MCL-321 trial (NCT04662255) is investigating pirtbrutinib and three other of BTK inhibitors.
In addition, CAR-T cell therapy has an important role for patients with MCL who have had multiple relapses, explained Habermann. FDA approves brexucabtagene autoleucel (Tecartus; formerly KTE-X19) was used for the treatment of adult patients with relapsed/refractory MCL in July 2020.
In addition, the phase 3 TRIANGLE trial (NCT02858258) showed that ibrutinib and standard chemoimmunotherapy, followed by autologous stem cell transplant (ASCT) and 2 years of ibrutinib maintenance, were superior to standard chemoimmunotherapy in younger patients with MCL. It was shown to significantly improve outcomes compared to induction and ASCT alone.