Treatment options for mantle cell lymphoma

Expert Opin Pharmacother. 2015;16(16):2497-507. doi: 10.1517/14656566.2015.1087507. Epub 2015 Sep 11.

Abstract

Introduction: In this article, we provide an accurate overview of both standard treatment option and novel promising therapeutics. Major impact is on novel agents now being tested in randomized clinical trials. While the initial data are promising, they may rapidly expand treatment options, change existing paradigms and further improve outcomes for mantle cell lymphoma (MCL) patients.

Areas covered: MCL is a disease with indolent histology, but aggressive clinical course. However, for now, MCL remains incurable and the search for the most effective and tumor-specific treatment still represents a great challenge for oncohematologists. However, the implementation of chemotherapy together with the anti-CD20 antibody rituximab, as well as the growing use of autologous stem cell transplantation in first remission, have improved effects of treatment in MCL, including even some improvement in overall survival. Recently, treatment modalities for MCL have been expanded by strategies based on several biologically targeted agents, including m-TOR kinase or proteasome inhibitors and immunomodulatory agents, such as lenalidomide. B-cell receptor pathway inhibitors, such as ibrutinib and idelalisib, and histone deacetylase or cyclin-dependent kinase inhibitors have also shown promising activity in resistant or relapsed disease.

Expert opinion: Although enormous progress was made in the treatment of MCL over the last year, the disease remains incurable. One chance for the significant life prolongation is intensive treatment with consolidative auto SCT. However, real progress may be afforded by developing the novel agents described in this article. In this way, MCL may soon become another potentially curable oncological malignancy.

Keywords: bortezomib; ibrutinib; immunochemotherapy; mantle cell lymphoma; stem cell transplantation; targeted treatment.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adenine / analogs & derivatives
  • Antineoplastic Agents / therapeutic use*
  • Drug Resistance, Neoplasm
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Immunologic Factors / therapeutic use
  • Lenalidomide
  • Lymphoma, Mantle-Cell / drug therapy
  • Lymphoma, Mantle-Cell / therapy*
  • Piperidines
  • Proteasome Inhibitors / therapeutic use
  • Protein Kinase Inhibitors / therapeutic use
  • Pyrazoles / therapeutic use
  • Pyrimidines / therapeutic use
  • Recurrence
  • Rituximab / therapeutic use
  • Thalidomide / analogs & derivatives
  • Thalidomide / therapeutic use

Substances

  • Antineoplastic Agents
  • Immunologic Factors
  • Piperidines
  • Proteasome Inhibitors
  • Protein Kinase Inhibitors
  • Pyrazoles
  • Pyrimidines
  • ibrutinib
  • Rituximab
  • Thalidomide
  • Lenalidomide
  • Adenine