Dr Pearse on the Current Treatment Paradigm for Relapsed/Refractory MCL

William B. Pearse, MD, assistant professor, medicine, University of California, San Diego School of Medicine, discusses the current treatment paradigm for patients with relapsed/refractory mantle cell lymphoma (MCL), highlighting the importance of early referral when treating these patients in the community setting.

Pearse begins by saying he strongly believes that integrating BTK inhibition into upfront treatment represents a significant advancement in patient treatment. The phase 3 TRIANGLE study (NCT02858258) offers valuable insights and, although its data is still evolving, the current findings are promising, advocating for the incorporation of BTK inhibition into frontline therapy, he says. BTK inhibitors may be particularly effective when combined with traditional, more aggressive induction regimens, such as rituximab (Rituxan) and cytarabine, for patients who can tolerate these regimens. Critical evaluation of the role of these drugs in frontline treatment strategies is imperative, Pearse reports.

He goes on to elucidate that MCL management poses unique challenges due to the rarity of the disease and its heterogeneous clinical presentation, which is influenced by both genetics and molecular mechanisms driving lymphomagenesis. Given this complexity, early patient referral to academic medical centers is advisable for optimal disease management, he implores. These centers offer access to a variety of clinical trials tailored to different disease stages and prior treatment exposures, Pearse notes. Establishing partnerships between academic institutions and community practices facilitates collaborative patient treatment and ensures access to clinical trials, which is particularly crucial for patients with TP53-mutated disease, he explains.

MCL management is evolving rapidly, with ongoing research shedding light on novel treatment approaches, Pearse continues. Pearse says it is important for oncologists to stay informed about emerging therapies and engage in multidisciplinary collaboration to optimize patient care. By leveraging academic resources and clinical trial opportunities, the MCL field can enhance treatment outcomes and provide tailored therapies to patients with MCL, addressing the complexities of this challenging disease, he concludes.