Treatment Options for Relapsed Mantle Cell Lymphoma

First-line Treatment Options for Relapsed MCL

The European Society for Medical Oncology recommends targeted approaches, including ibrutinib and lenalidomide, as primary treatment options for patients with relapsed mantle cell lymphoma, with temsirolimus and bortezomib preferably combined with chemotherapy 1, 2
BTK inhibitors, such as ibrutinib, show the highest efficacy among single agents with an overall response rate of 68-72% and median progression-free survival of 13.9-14.6 months in patients with relapsed mantle cell lymphoma 4, 5
Immunomodulatory drugs, such as lenalidomide, demonstrate response rates of 28-46% as monotherapy with median progression-free survival of 4-8.8 months in patients with relapsed mantle cell lymphoma 4, 6
Combination therapy with ibrutinib plus rituximab achieves an impressive 88% response rate with 44% complete responses in patients with relapsed mantle cell lymphoma 7, 5

The European Society for Medical Oncology suggests that allogeneic stem cell transplantation should be discussed as a potentially curative option in chemosensitive disease for younger patients (<65 years) with relapsed mantle cell lymphoma 1, 2
Targeted therapy prior to transplant, such as ibrutinib or lenalidomide, can be considered to achieve optimal disease control before transplant in patients with relapsed mantle cell lymphoma 4
Less intensive combinations, such as lenalidomide plus rituximab, offer a 57% response rate with 36% complete responses in elderly or unfit patients with relapsed mantle cell lymphoma 4, 7

Temsirolimus plus chemotherapy, such as bendamustine-rituximab, shows an 87% response rate with 8% complete responses in patients with relapsed mantle cell lymphoma 4, 5
Bortezomib should preferably be combined with chemotherapy rather than used as monotherapy in patients with relapsed mantle cell lymphoma 1