Dr. Rule on the Future Treatment Paradigm in MCL

Simon Rule, MD, PhD, professor of hematology, Plymouth University Medical School, United Kingdom, discusses what the treatment landscape of mantle cell lymphoma (MCL) may look like in the next decade.

Chemotherapy could no longer play a role in the MCL treatment paradigm, says Rule. Frontline treatment for both younger and older patients could consist of a BCL-2 inhibitor, BTK inhibitor, and an antibody.

For younger patients, minimal residual disease (MRD) could shed light on whether or not to supplement treatment with allogenic stem cell transplant, or potentially, CAR T-cell therapy, explains Rule. Additionally, MRD could serve as a signal to stop treatment in older patients.

As allogenic stem cell transplant and CAR T-cell therapy are associated with additional toxicities, single-agent BTK inhibitors, or potentially BTK inhibitors in combination with an antibody could prove to be the optimal treatment for frail and elderly patients with MCL.