“The End of the Golden Weather”: therapeutic strategies for mantle cell lymphoma relapsed or refractory to covalent BTK inhibitors

Mantle cell lymphoma (MCL) is a subtype of non-Hodgkin lymphoma which is often characterised by a pattern of continued relapse after frontline chemoimmunotherapy. Although patients are usually able to regain durable disease control with covalent Bruton’s tyrosine kinase inhibitors (cBTKi) at first...

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Main Authors: Brian T. Grainger, Chan Y. Cheah
Format: Article
Language:English
Published: Ferrata Storti Foundation 2024-11-01
Series:Haematologica
Online Access:https://haematologica.org/article/view/11822
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author Brian T. Grainger
Chan Y. Cheah
author_facet Brian T. Grainger
Chan Y. Cheah
author_sort Brian T. Grainger
collection DOAJ
description Mantle cell lymphoma (MCL) is a subtype of non-Hodgkin lymphoma which is often characterised by a pattern of continued relapse after frontline chemoimmunotherapy. Although patients are usually able to regain durable disease control with covalent Bruton’s tyrosine kinase inhibitors (cBTKi) at first relapse, it is now appreciated that such responses are often not sustained and the management of such patients represents a significant area of unmet need. There is an imperative to better understand resistance mechanisms and identify high-risk subsets of patients for whom cBTKi responses may be particularly short. Allogeneic stem cell transplant has an established role in appropriate candidates, however contemporary consensus is to preferentially offer chimeric antigen receptor (CAR) T-cell therapy. In this Review, we consider the available data on both existing and emerging treatment options, including non-covalent BTK inhibitors, bispecific antibodies, antibody-drug conjugates and Bcl-2 inhibitors and propose a treatment strategy prioritising clinical trials where available.
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spelling doaj-art-e4bb7e68c56d4391b9ebe4fcc2481c872024-11-14T19:41:15ZengFerrata Storti FoundationHaematologica0390-60781592-87212024-11-01999110.3324/haematol.2024.286205“The End of the Golden Weather”: therapeutic strategies for mantle cell lymphoma relapsed or refractory to covalent BTK inhibitorsBrian T. Grainger0Chan Y. Cheah1Department of Haematology, Sir Charles Gairdner Hospital, Nedlands, WADepartment of Haematology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia; Linear Clinical Research, Nedlands, WA, Australia; Medical School, University of Western Australia, Nedlands, WA Mantle cell lymphoma (MCL) is a subtype of non-Hodgkin lymphoma which is often characterised by a pattern of continued relapse after frontline chemoimmunotherapy. Although patients are usually able to regain durable disease control with covalent Bruton’s tyrosine kinase inhibitors (cBTKi) at first relapse, it is now appreciated that such responses are often not sustained and the management of such patients represents a significant area of unmet need. There is an imperative to better understand resistance mechanisms and identify high-risk subsets of patients for whom cBTKi responses may be particularly short. Allogeneic stem cell transplant has an established role in appropriate candidates, however contemporary consensus is to preferentially offer chimeric antigen receptor (CAR) T-cell therapy. In this Review, we consider the available data on both existing and emerging treatment options, including non-covalent BTK inhibitors, bispecific antibodies, antibody-drug conjugates and Bcl-2 inhibitors and propose a treatment strategy prioritising clinical trials where available. https://haematologica.org/article/view/11822
spellingShingle Brian T. Grainger
Chan Y. Cheah
“The End of the Golden Weather”: therapeutic strategies for mantle cell lymphoma relapsed or refractory to covalent BTK inhibitors
Haematologica
title “The End of the Golden Weather”: therapeutic strategies for mantle cell lymphoma relapsed or refractory to covalent BTK inhibitors
title_full “The End of the Golden Weather”: therapeutic strategies for mantle cell lymphoma relapsed or refractory to covalent BTK inhibitors
title_fullStr “The End of the Golden Weather”: therapeutic strategies for mantle cell lymphoma relapsed or refractory to covalent BTK inhibitors
title_full_unstemmed “The End of the Golden Weather”: therapeutic strategies for mantle cell lymphoma relapsed or refractory to covalent BTK inhibitors
title_short “The End of the Golden Weather”: therapeutic strategies for mantle cell lymphoma relapsed or refractory to covalent BTK inhibitors
title_sort the end of the golden weather therapeutic strategies for mantle cell lymphoma relapsed or refractory to covalent btk inhibitors
url https://haematologica.org/article/view/11822
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