Future Directions for CAR T in MCL


Frederick Locke, MD, considers whether CAR T will gain a more significant role in mantle cell lymphoma and if it will move to the frontline setting.

Frederick Locke, MD: CAR [chimeric antigen receptor] T-cell therapy may gain a more significant role in the treatment of mantle cell lymphoma. As we better understand high-risk features in patients, we’ll know who those patients are to give CAR T-cell to early. Well-designed clinical trials need to test that. Novel clinical trials could try things like a lead-in of a BTK inhibitor as frontline therapy and then give CAR T after a number of cycles. That’s 1 way to get CAR T-cell therapy early to very high-risk patients. CAR T-cell therapy offers an opportunity for long-term ongoing durable remissions for patients who are without other options. We know that patients who have been exposed or are refractory to a BTK inhibitor don’t have great options, and CAR T-cell therapy offers the opportunity for remissions in those patients. It is a paradigm-changing treatment option.

CAR T-cell therapy is an innovative new therapy for patients. At this point, it’s not something that is easily administered and can be done in the community oncologist’s office, but that does not take away from the reality that CAR T-cell therapy can lead to ongoing durable remissions for patients with mantle cell lymphoma who are without other treatment options. These patients need to be considered for CAR T-cell therapy as early as possible and have a discussion with the CAR T-cell therapy treatment center that’s nearest or dearest to the community oncologist. Please do not deny patients the opportunity for this therapy. They certainly can benefit from it, and it’s not age dependent. We certainly look at comorbidities and other features. CAR T-cell therapy can lead to impressive and durable responses.

This transcript was edited for clarity.

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