Treatment Landscape of Relapsed/Refractory Mantle Cell Lymphoma: An Updated Review

Mantle cell lymphoma (MCL) accounts for nearly 2-6% of all non-Hodgkin lymphoma (NHL) cases, with a steady incidence increase over the past few decades. Although many patients achieve an adequate response to the upfront treatment, the short duration of remission with rapid relapse is challenging during MCL management. In this regard, there is no consensus on the best treatment options for relapsed/refractory (R/R) disease, and the international guidelines demonstrate wide variations in the recommended approaches. The last decade has witnessed the introduction of new agents in the treatment landscape of R/R MCL. Since the introduction of Bruton's tyrosine kinase (BTK) inhibitors, the treatment algorithm and response of R/R MCL patients have dramatically changed. Nevertheless, BTK resistance is common, necessitating further investigations to develop novel agents with a more durable response. Novel agents targeting the B-cell receptor (BCR) signaling have exhibited clinical activity and a well-tolerable safety profile. However, as the responses to these novel agents are still modest in most clinical trials, combination strategies were investigated in pre-clinical and early clinical settings to determine whether the combination of novel agents would exhibit a better durable response than single agents. In this report, we provide an updated literature review that covers recent clinical data about the safety and efficacy of novel therapies for the management of R/R MCL.

Automated summary

Mantle cell lymphoma (MCL) accounts for a small percentage of non-Hodgkin lymphoma cases, but its incidence has been increasing steadily. The management of relapsed/refractory MCL remains challenging, with wide variations in recommended treatment approaches. The introduction of new agents, particularly BTK inhibitors, has significantly changed the treatment landscape for R/R MCL patients. However, BTK resistance is common, necessitating further research for more durable responses. Novel agents targeting B-cell receptor signaling have shown clinical activity and tolerable safety profiles. Combination strategies have been investigated to improve the response rates. This report provides an updated literature review on the safety and efficacy of novel therapies for the management of R/R MCL.