Mantle cell lymphoma future or investigational therapies

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ali Akram, M.B.B.S.[2]

• Recent advances in the understanding of the pathogenesis of mantle cell lymphoma have led to the development of targeted therapies which have shown potential promise as effective therapeutic approaches in the future..
• In addition to the ongoing assessment of new monoclonal antibody-based therapies, the continued development of targeted molecular signaling inhibitors based on the underlying biology of MCL is an approach that will potentially yield fruitful results in this disease.
• Some of the current therapies under clinical investigation are as follows:
  • BCL-2 inhibitor venetoclax (ABT-199) and the phosphatydilinosytol 3-kinase δ (PI3K δ) inhibitor idelalisib were tested in a phase I study and have shown promising results.^[1][2]
  • Chimeric antigen receptor T-cell (CAR-T) therapy is being used in a phase II study of CAR-T therapy in relapsed MCL.^[3]
  • Due to the male to female predominance of approximately 4:1 in MCL, investigators are investigating androgen receptor (AR) blockers like enzalutamide as means of decreasing MCL cell proliferation.^[4]
  • A few next-generation proteasome inhibitors (carfilzomib, oprozomib, ixazomib) are undergoing clinical testing in MCL and have shown an acceptable safety profile in bortezomib-resistant MCL patients.^[5]

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