Despite many recent therapeutic advances, mantle cell lymphoma (MCL) remains a largely incurable disease. Treatments for patients with relapsed/refractory (R/R) disease are limited in number and in response durability. Therefore, improving the efficacy of frontline (1L) treatment, and specifically maximizing the duration of first remission, remains of critical importance to obtain favorable long-term outcomes. As 1L treatments become more effective, improving tolerability is also becoming an increasingly realistic goal. Targeted agents, which are now mainstays of treatment in R/R MCL, are establishing new, paradigm-changing roles in frontline treatment. Here, we review data supporting current standard-of-care (SOC) approaches and explore six main areas of possible focus for advancement of 1L management: optimizing the chemoimmunotherapy (CIT) backbone, adding targeted agents to CIT, redefining the role of autologous stem cell transplantation (ASCT), improving maintenance therapy, using targeted agent combinations with omission of CIT, and employing MRD-guided therapy. We highlight several ongoing phase 3 trials that may soon impact frontline MCL management and outline some areas of necessary investigation as the field continues to strive towards a cure for this disease.
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Review Article|
March 18, 2024
Frontline Treatment of Mantle Cell Lymphoma
Clinical Trials & Observations
Christine E Ryan,
Christine E Ryan
Dana-Farber Cancer Institute, Boston, Massachusetts, United States
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Philippe Armand,
Philippe Armand
Dana-Farber Cancer Institute, Boston, Massachusetts, United States
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Ann S LaCasce
Dana-Farber Cancer Institute, Boston, Massachusetts, United States
* Corresponding Author; email: [email protected]
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Blood blood.2023022352.
Article history
Submitted:
January 8, 2024
Revision Received:
February 26, 2024
Accepted:
February 29, 2024
Citation
Christine E Ryan, Philippe Armand, Ann S LaCasce; Frontline Treatment of Mantle Cell Lymphoma. Blood 2024; blood.2023022352. doi: https://doi.org/10.1182/blood.2023022352
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