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Review
. 2024 May 25:15:239-254.
doi: 10.2147/JBM.S463946. eCollection 2024.

Real-World Evidence of Relapsed/Refractory Mantle Cell Lymphoma Patients and Treatments: A Systematic Review

Juan-Manuel Sancho  1 , Marc Sorigué  1 , Eva Rubio-Azpeitia  2
Affiliations
Review

Real-World Evidence of Relapsed/Refractory Mantle Cell Lymphoma Patients and Treatments: A Systematic Review

Juan-Manuel Sancho et al. J Blood Med. .

Abstract

Introduction: Mantle cell lymphoma (MCL) is an incurable disease with an aggressive clinical course, and most patients eventually relapse after chemotherapy. Targeted therapies developed for relapsed/refractory MCL have been approved based on clinical trial data. However, real-world setting data are scarce and scattered.

Areas covered: This systematic review aimed to collect, synthesize, and describe the characteristics and treatment outcomes of patients with relapsed/refractory MCL after receiving a second or subsequent line of therapy in the real-world setting.

Expert opinion: R/R MCL is clinically and biologically heterogeneous and still represents a therapeutic challenge, with high-risk and early relapsed patients remaining an unmet medical need. This systematic review is limited by the quality of the available data and the difficulty of comparing outcomes in R/R MCL due to the heterogeneity of the disease, but the results suggest that covalent BTKis should be positioned as second-line therapy, followed by CAR T-cells in BTK-i-relapsed patients. Chemo-free and combination therapies with established chemoimmunotherapy backbones in the relapsed and front-line settings have been recently developed, and front-line options are being improved to move targeted and cellular therapies to earlier lines, including front-line therapy, in elderly and younger fit patients. In the upcoming years, many new targeted agents will play an important role and will be incorporated to the routine practice as their sequence, and outcomes in unselected patients are determined.

Keywords: CAR-T cells; ibrutinib; mantle cell lymphoma; real-world evidence; relapsed/refractory mantle cell lymphoma (R/R MCL); treatment efficacy.

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Conflict of interest statement

JMS has received honoraria for consultancy or advisory role from AbbVie, Janssen, Roche, Gilead-Kite, Lilly, Beigene, Novartis, Incyte, and BMS-Celgene and received honoraria as speaker in medical education activities organized by Janssen, Roche, Gilead-Kite, Incyte, and BMS-Celgene. ERA is a Janssen employee. MS declares no conflicts of interest in this work.

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