Dr. Visco on Next Steps for the MANTLE-FIRST Trial in Relapsed/Refractory MCL

Carlo Visco, MD, an associate professor within the Department of Medicine and Section of Hematology at the University of Verona, in Verona, Italy, discusses the next steps for the international, retrospective MANTLE-FIRST trial in patients with relapsed/refractory mantle cell lymphoma (MCL).

In the MANTLE-FIRST trial, investigators evaluated the outcomes of younger patients with MCL who had progressive disease or first relapse following treatment with high-dose cytarabine and autologous stem cell transplantation. Two next steps should be explored with this study, says Visco.

The first step is biological; the field needs to understand why these patients fare worse than others and why some relapse early when they are treated with drugs such as ibrutinib (Imbruvica), cytarabine, or rituximab (Rituxan), says Visco. Additionally, the biology of tumors that harbor p53 mutations must be analyzed; this means utilizing more gene sequencing to determine mutational status, explains Visco.

The Italian Lymphoma Foundation (FIL) has sponsored another trial, which will investigate these biological factors further, says Visco. The second step will be to examine patients who relapse later on. A study like that will take place next year in Europe. The follow-up of these patients will be longer and yield more mature data that can be analyzed to see what happens in the later-line setting, concludes Visco.