Dr. Karmali on Novel Agents in Relapsed/Refractory MCL

Reem Karmali, MD, MS, assistant professor of medicine, Northwestern University Feinberg School of Medicine, discusses the use of novel agents in patients with relapsed/refractory mantle cell lymphoma (MCL).

Despite best efforts, MCL remains an incurable disease, says Karmali. However, several advances have resulted in improvements in survival. Most notably, the BTK inhibitors ibrutinib (Imbruvica) and acalabrutinib (Calquence) which have shown significant activity in the relapsed/refractory setting. Investigators anticipated that these agents would result in high response rates since BTK is an important protein of B-cell receptor signaling, which is a critical component of MCL differentiation, proliferation, and survival, explains Karmali. To date, both agents have shown response rates as high as 70% to 80%.

Given the impressive activity of these agents in such a heavily pretreated patient population, researchers are hoping to move these agents into earlier lines of therapy. However, whether their efficacy will translate to the frontline setting remains unclear, says Karmali.