Dr Phillips on Efforts to Clarify and Refine Management Approaches in Relapsed/Refractory MCL

Tycel Phillips, MD, associate professor, Division of Lymphoma, Department of Hematology & Hematopoietic Cell Transplantation, City of Hope, discusses highlights from the 2024 OncLive® Bridging the Gaps in Hematologic Malignancies meeting, and expands on efforts to clarify and optimize the role of current approaches to the treatment of patients with mantle cell lymphoma (MCL).

During the MCL session of the Bridging the Gaps in Hematologic Malignancies meeting, there was extensive discussion of ongoing challenges in managing MCL, both in the United States and globally, Phillips begins. The session also placed particular emphasis on evolving treatment paradigms in the frontline setting, he explains, adding that there remains considerable disagreement regarding the optimal induction regimen and the role of transplantation in patient management.

The development of novel treatments in the relapsed/refractory setting may be improving prospects for patients, he continues. Notably, CAR T-cell therapies have great potential in this space, pending their approval for associated indications, Phillips reports. These therapies include brexucabtagene autoleucel (brexu-cel; Tecartus) and lisocabtagene maraleucel (liso-cel; Breyanzi). Brexu-cell gained FDA approval in July 2020 based on findings from the phase 2 ZUMA-2 trial, and liso-cel is currently being evaluated in the phase 1 TRANSCEND NHL 001 trial (NCT02631044) for patients with relapsed/refractory mantle cell lymphoma.

The emergence of bispecific antibodies and BTK inhibitors further enriches the therapeutic armamentarium in MCL, Phillips says. However, the question of treatment sequencing and the potential for treatment reuse remain pertinent, he adds.

Discussions during the MCL session also centered on strategies to improve outcomes for high-risk patients and enhance the identification of this subgroup, he expands. Efforts to minimize the use of cytotoxic chemotherapy in favor of more effective and durable therapies garnered attention, Phillips states. Numerous studies are showing that chemotherapy yields limited and transient responses, potentially fostering the emergence of resistant clones, he adds. Thus, there's a collective focus on refining patient management strategies to optimize outcomes in this challenging patient population, Phillips concludes.