Dr. Goy on Maintenance Strategies in MCL Treatment

Andre Goy, MD, MS, chairman and director, chief of Lymphoma, and director of Clinical and Translational Cancer Research at John Theurer Cancer Center, discusses maintenance strategies for treating patients with mantle cell lymphoma (MCL).

The consensus among researchers and physicians in MCL is that patients who are young and fit can benefit with a dose-intensive regimen containing cytarabine with or without stem cell consolidation, Goy explains. This approach is found to extend progression-free survival (PFS) by 5 to 7 years. This has become the standard of care, he adds, after results of a large randomized trial demonstrated the PFS benefit with cytarabine. The reason for this is that patients achieve a deeper molecular complete response. Also, in MCL, minimal-residual disease (MRD) is a factor that is becoming very important.

Necessary improvements in the field include exploring maintenance strategies, one of which includes 4 cycles of R-DHAP followed by autologous transplant. This equated to a survival benefit with maintenance with rituximab (Rituxan) by 3 years versus observation. The maintenance therapy approach has had a benefit in both the elderly and young populations, Goy says, adding that the goal is to obtain a more durable response as the majoriy of patients do develop resistance to chemotherapy.