Dr. Skarbnik on Current Treatment Strategies Making Waves in MCL

Alan P. Z. Skarbnik, MD, a hematologist/oncologist with Novant Health, discusses frontline and recurrent treatment strategies for patients with mantle cell lymphoma (MCL).

MCL is generally treated more aggressively in the frontline setting with a high dose of a cytarabine-containing induction regimen, Skarbnik says. This is followed by other aggressive strategies, such as high-dose chemotherapy and autologous stem cell transplant. This strategy tends to lead to longer remissions and progression-free survival compared with other frontline approaches, adds Skarbnik.

The most pressing challenge is in patients who experience recurrent disease 1-3 years following an intensive frontline treatment, Skarbnik explains. These patients are often at a higher risk of resistance to second-line therapies and early risk of progression following a second-line treatment.

BTK inhibitors thus far have been the therapy of choice in the second-line setting due to a handful of factors, including the fact that they're easy to take, accessible, well tolerated, and yield promising responses. The primary challenge, Skarbnik says, is that the duration of response achieved with these agents is not very impressive. CAR T-cell therapy could represent another promising option in this setting, Skarbnik concludes.