Exploring Unmet Needs and BTK Inhibitors in the MCL Population

August 20, 2020

Nilanjan Ghosh, MD, discusses the current unmet needs in mantle cell lymphoma and how Bruton’s tyrosine kinase inhibitors are being looked at to fill that need for patients with high-risk disease in the first line.

Nilanjan Ghosh, MD, a hematologist and medical oncologist at the Levine Cancer Institute, Atrium Health, discusses the current unmet needs in mantle cell lymphoma (MCL) and how Bruton’s tyrosine kinase (BTK) inhibitors are being looked at to fill that need for patients with high-risk disease in the first line.

In patients with MCL, BTK inhibitors are used for relapsed/refractory disease. Ghosh says that the results are better if BTK inhibitors are used at treatment earlier in the disease course versus later. Patients with high-risk disease, such as those who have a TP53 mutation, deletion, or those who have blastoid morphology, typically do poorly with standard treatments compared to patients with low-risk disease.

If you move BTK inhibitors to the frontline space, how does that compare with standard treatments in this patient population? Ghosh thinks this is an important question in the MCL setting. Trials are ongoing looking at that question for these patients. The PCYC 1143 trial (NCT03112174) is looking at ibrutinib (Imbruvica), a BTK inhibitor, and venetoclax (Venclexta) for high-risk patients, like those with TP53 or older patients in the frontline setting. These are unmet needs in this disease landscape.

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