Dr. Lee on B-Cell Receptor Targeting in Relapsed/Refractory MCL

Hun Ju Lee, MD, an associate professor of medicine in the Department of Lymphoma & Myeloma and the Jessica and Jeffrey Brue Endowed Professor of Lymphoma Research at The University of Texas MD Anderson Cancer Center, discusses B-cell receptor targeting in relapsed/refractory mantle cell lymphoma (MCL).

In the phase 1b/2 study investigators enrolled patients with MCL and chronic lymphocytic leukemia and treated them with a combination of cirmtuzumab and ibrutinib. They found that one of the proliferative survival signals is complementary to another system of proteins referred to as immunoglobulin, which is the B-cell receptor, says Lee. B-cell receptortargeting has been tremendous with BTK inhibitors, such as ibrutinib (Imbruvica) and idelalisib (Zydelig), says Lee. For all these pathways, targeting has generated several treatment options for many patients. However, the difficulty with ibrutinib and idelalisib, as well as the PI3K and BTK inhibitors, is that they do not yield an 100% complete remission, adds Lee.

As such, investigators want to understand how these B cells are surviving and they want to learn more about the patients who are primary refractory as well as those who respond initially to treatment and then relapse.Understanding where the cells are coming from and what the survival rate looks like is another area of active research. Treating patients with relapsed/refractory MCL is similar to playing chess with lymphoma cells because they are using biological mechanisms to obtain a survival advantage, concludes Lee.