Dr. Skarbnik on the Optimization of CAR T-Cell Therapy Sequencing in MCL

Alan P. Z. Skarbnik, MD, a hematologist/oncologist with Novant Health, discusses the optimization of treatment sequencing with CAR T-cell therapy in mantle cell lymphoma (MCL).

The long-term efficacy with CAR T-cell therapy in MCL is not yet fully understood, says Skarbnik. Additionally, it is unknown whether sequencing CAR T-cell therapy before a BTK inhibitor affects response rate or duration of response in this patient population, Skarbnik says. Retrospective data could inform whether that sequencing strategy is feasible and efficacious, Skarbnik adds.

Currently, CAR T-cell therapy appears to have the most utility after frontline induction therapy in younger patients with MCL who experience early recurrence and have undergone transplant, Skarbnik says. Additionally, the modality is warranted in patients who recur after treatment with BTK inhibitors because few available agents are able to salvage these patients, Skarbnik says. In addition to CAR T-cell therapy, rituximab (Rituxan) plus bendamustine and low-dose cytarabine has demonstrated good response rates in patients with MCL who have relapsed on or are refractory to BTK inhibitors, concludes Skarbnik.