Dr Phillips on Future Avenues for Improving the Management of High-Risk MCL

"We're doing better, but we can do more for those high-risk patients with MCL. We all need to get a better idea of how to identify patients who probably do not need to be exposed to chemotherapy. Identifying clinical trials that would be best for these patients is still very important."

Tycel J. Phillips, MD, MPH, associate professor, Division of Lymphoma, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, discusses aspects of mantle cell lymphoma (MCL) management that require improvement, particularly for patients with high-risk disease.

Substantial progress has been made in the management of MCL, but there is still considerable work to be done, particularly for higher-risk patients, Phillips begins. A critical aspect of improving patient outcomes lies in identifying those who may not require chemotherapy early in the treatment process. This can be achieved through comprehensive molecular testing and cytogenetic analysis during bone marrow biopsies, he states. Identifying patients who are at higher risk and may benefit from alternative treatment approaches is essential to avoid unnecessary exposure to chemotherapy.

For high-risk MCL patients, clinical trials remain a vital avenue for exploring novel therapeutic options, Phillips continues. Thus, increasing the enrollment of MCL patients in clinical trials, particularly those focused on high-risk groups, is crucial for advancing treatment strategies, he emphasizes.

In the United States (US), there is a pressing need for greater cooperation in clinical trial efforts, Phillips notes. Compared with Europe, the US has fewer large randomized trials, which hampers the ability to establish robust evidence for the most effective treatments. Strengthening collaborative efforts across institutions and research networks will be key to enhancing the development of new therapies, Phillips explains.

Overall, improving early diagnosis, refining risk stratification, and promoting broader clinical trial participation will be crucial for better outcomes in MCL, especially for patients with high-risk disease, he concludes.