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Relapsed/Refractory Mantle Cell Lymphoma: Beyond BTK Inhibitors

Mantle cell lymphoma (MCL) is a rare mature B-cell non-Hodgkin lymphoma (B-NHL) with historically poor outcomes. Virtually all patients will eventually experience refractory or relapsed (R/R) disease, with a virulent course of resistance and serial relapses, making treatment challenging. The availab...

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Autores principales: Burkart, Madelyn, Karmali, Reem
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8954159/
https://www.ncbi.nlm.nih.gov/pubmed/35330376
http://dx.doi.org/10.3390/jpm12030376
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author Burkart, Madelyn
Karmali, Reem
author_facet Burkart, Madelyn
Karmali, Reem
author_sort Burkart, Madelyn
collection PubMed
description Mantle cell lymphoma (MCL) is a rare mature B-cell non-Hodgkin lymphoma (B-NHL) with historically poor outcomes. Virtually all patients will eventually experience refractory or relapsed (R/R) disease, with a virulent course of resistance and serial relapses, making treatment challenging. The available therapies for R/R MCL are not curative with conventional therapy, their goal being to palliate and prolong survival. A variety of agents approved for R/R MCL, including Bruton’s tyrosine kinase inhibitors (BTKi), changed the treatment landscape of R/R MCL. In the pre-BTKi era, the median progression-free survival (PFS) in R/R disease was 4–9 months. With the introduction of ibrutinib, the median PFS improved to 13–14.6 months. Despite these impressive results, the duration of response is limited, and resistance to BTKi inevitably develops in a subset of patients. Outcomes after progression on BTKi are extremely poor, with a median overall survival (OS) of 6 to 10 months. Certain therapies, such as chimeric antigen receptor (CAR) T cells, have shown promising results after BTKi failure. The preferred combination and sequencing of therapies beyond BTKi remain unestablished and are currently being investigated. In this review, we describe the current evidence for the available treatment of R/R MCL after progression on BTKi.
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spelling pubmed-89541592022-03-26 Relapsed/Refractory Mantle Cell Lymphoma: Beyond BTK Inhibitors Burkart, Madelyn Karmali, Reem J Pers Med Review Mantle cell lymphoma (MCL) is a rare mature B-cell non-Hodgkin lymphoma (B-NHL) with historically poor outcomes. Virtually all patients will eventually experience refractory or relapsed (R/R) disease, with a virulent course of resistance and serial relapses, making treatment challenging. The available therapies for R/R MCL are not curative with conventional therapy, their goal being to palliate and prolong survival. A variety of agents approved for R/R MCL, including Bruton’s tyrosine kinase inhibitors (BTKi), changed the treatment landscape of R/R MCL. In the pre-BTKi era, the median progression-free survival (PFS) in R/R disease was 4–9 months. With the introduction of ibrutinib, the median PFS improved to 13–14.6 months. Despite these impressive results, the duration of response is limited, and resistance to BTKi inevitably develops in a subset of patients. Outcomes after progression on BTKi are extremely poor, with a median overall survival (OS) of 6 to 10 months. Certain therapies, such as chimeric antigen receptor (CAR) T cells, have shown promising results after BTKi failure. The preferred combination and sequencing of therapies beyond BTKi remain unestablished and are currently being investigated. In this review, we describe the current evidence for the available treatment of R/R MCL after progression on BTKi. MDPI 2022-03-01 /pmc/articles/PMC8954159/ /pubmed/35330376 http://dx.doi.org/10.3390/jpm12030376 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Burkart, Madelyn
Karmali, Reem
Relapsed/Refractory Mantle Cell Lymphoma: Beyond BTK Inhibitors
title Relapsed/Refractory Mantle Cell Lymphoma: Beyond BTK Inhibitors
title_full Relapsed/Refractory Mantle Cell Lymphoma: Beyond BTK Inhibitors
title_fullStr Relapsed/Refractory Mantle Cell Lymphoma: Beyond BTK Inhibitors
title_full_unstemmed Relapsed/Refractory Mantle Cell Lymphoma: Beyond BTK Inhibitors
title_short Relapsed/Refractory Mantle Cell Lymphoma: Beyond BTK Inhibitors
title_sort relapsed/refractory mantle cell lymphoma: beyond btk inhibitors
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8954159/
https://www.ncbi.nlm.nih.gov/pubmed/35330376
http://dx.doi.org/10.3390/jpm12030376
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