Dr Kahl on Ongoing and Planned Investigations Within the Landscape of MCL

Brad S. Kahl, MD, professor, Department of Medicine, Oncology Division, Washington University School of Medicine in St. Louis, discusses ongoing and planned investigations within the landscape of mantle cell lymphoma (MCL).

The MCL treatment landscape is currently undergoing significant changes, Kahl says, citing the 2022 publication of data from the phase 3 SHINE trial (NCT01776840), which was performed in older patients with MCL. Furthermore, the phase 3 TRIANGLE study (NCT02858258) was conducted, and there is now an attempt to advance pirtobrutinib (Jaypirca) into earlier lines of therapy, he details. Additionally, findings are expected to read out from trials such as the phase 3 ECHO trial (NCT02972840), which assessed the combination of acalabrutinib (Calquence) with bendamustine and rituximab (Rituxan) as a frontline treatment, and the phase 3 MANGROVE trial (NCT04002297), which evaluated zanubrutinib (Brukinsa) with rituximab in a similar patient population, Kahl explains. Overall, covalent BTK inhibitors may become a common frontline treatment choice for patients with MCL within the coming years, Kahl adds.

Additional noncovalent BTK inhibitors are in the pipeline, such as nemtabrutinib (MK-1026, formerly ARQ-531), Kahl expands. Notably, these agents have limited available data at this point, he says. However, whether they will significantly differ from the noncovalent BTK inhibitor pirtobrutinib is uncertain. Therefore, more research is needed to answer questions regarding these agents, Kahl notes. Nonetheless, investigators are closely monitoring the development of these emerging treatments, he adds.

At the 2022 ASH Annual Meeting, investigators presented data on glofitamab-gxbm (Columvi) in patients with relapsed MCL, Kahl continues, saying that he is eager to see more data with bispecific antibodies in the context of relapsed MCL because of the limited number of current treatment options for this patient group. The MCL landscape needs better treatment alternatives, Kahl emphasizes. Overall, Kahl concludes that he is hopeful that bispecific antibodies will be a valuable addition to the MCL treatment paradigm and offer improved choices for patients with MCL facing relapse.