Ongoing clinical trials are exploring novel chemotherapy-free regimens for mantle cell lymphoma (MCL), offering hope for improved outcomes and reduced toxicity. Alexey Danilov, MD, PhD, of City of Hope, highlights several promising investigations into the treatment of patients with MCL.
Combination Therapies in High-Risk MCL
One notable phase 1/2 trial (NCT05861050) is evaluating the combination of glofitamab-gxbm (Columvi), venetoclax (Venclexta), lenalidomide (Revlimid), and obinutuzumab (Gazyva) in patients with high-risk MCL. This includes patients with TP53 mutations, complex karyotypes, or other high-risk features. This approach, pioneered by Tycel Phillips, MD, aims to provide effective treatment while avoiding the toxicities associated with traditional chemotherapy.
Frontline Treatment for Standard-Risk MCL
A phase 1 trial (NCT03523975) is exploring the combination of venetoclax, lenalidomide, and rituximab as a frontline treatment for patients with standard-risk MCL. This chemotherapy-free regimen seeks to improve initial response rates and long-term outcomes in this patient population.
Nemtabrutinib and Rituximab in MCL
Nemtabrutinib (ARQ-53), a novel BTK inhibitor, is also under investigation in combination with rituximab for patients with MCL. Danilov will serve as the principal investigator of this trial, which aims to assess the efficacy and safety of this combination in both frontline and relapsed settings.
Advancements in Relapsed MCL
In addition to these trials, investigators are conducting several studies in patients with relapsed MCL, which involve CAR T-cell therapy, bispecific antibodies, and glofitimab. These approaches offer potential new therapeutic options for patients who have relapsed after initial treatment.
Broader Implications for Hematologic Malignancies
These trials may spur significant advances in the treatment of patients with hematologic malignancies. Danilov encourages patients to inquire about their eligibility for clinical trials, emphasizing that second opinions are often valuable when making treatment decisions. Clinical trials may offer new therapeutic options with the potential for better outcomes, and by participating in these innovative studies, patients have the opportunity to access cutting-edge treatments that may significantly improve both survival and quality of life.
