Dr. Goy on Future Treatment Approaches in MCL

Andre Goy, MD, MS, chief, Division of Lymphoma, chairman and director, John Theurer Cancer Center, discusses future treatment approaches in patients with mantle cell lymphoma (MCL).

BTK inhibitors like ibrutinib (Imbruvica) and, most recently, the second-generation inhibitor acalabrutinib (Calquence) have been established as the standard of care for patients in the relapsed/refractory setting. In the salvage setting, these agents are also showing benefit in combination with rituximab (Rituxan), says Goy. He also predicts that the combination of ibrutinib and venetoclax (Venclexta) is going to move to the frontline setting.

Moreover, the R-BAC regimen (rituximab, cytarabine, and bendamustine) is leading to impressive responses outside of a clinical trial, even in patients with relapsed disease. Goy adds that if the dose of cytarabine is adjusted, this regimen is also feasible in elderly, frail patients.

Moving forward, it is going to be crucial to do a full pathology of the patient’s lymphoma to see if they have high-risk markers, including p53 and Ki-67 mutations.