Treatment of Relapsed or Refractory Mantle Cell Lymphoma in BTKi-Naïve Patients After First-Line Immunochemotherapy
When mantle cell lymphoma recurs or fails to respond following initial immunochemotherapy, and the patient has not previously received a BTK inhibitor, a defined therapeutic direction is available. The approach addresses both typical disease progression and the less common scenario of central nervous system involvement.
Clinical Scenario
Relapsed or refractory mantle cell lymphoma in patients who are BTKi-naïve — that is, who have not previously been treated with a BTK inhibitor. The relevant clinical situations include early and late progression of disease following first-line immunochemotherapy, as well as CNS relapse in this population.
Treatment Approach — Partial Overview
For BTKi-naïve patients who relapse after first-line immunochemotherapy, the recommended approach centres on a covalent BTK inhibitor. The protocol specifies whether an additional targeted agent is appropriate and in which clinical situations — covering both standard progression scenarios and CNS relapse.
Complete regimen details, agent selection, combination criteria, and line-specific recommendations are in the full protocol below.
References
DOI: 10.1002/hem3.70233
- For BTKi‐naïve patients with relapsed MCL, a cBTKi ± venetoclax (the latter not EMA‐ or FDA‐approved) should be offered as standard post‐first‐line immunochemotherapy for:
- Second line rather than later lines in early and late POD [III, B].
- CNS relapse in BTKi‐naive patients [IV, B].
View source ↗