The treatment landscape for mantle cell lymphoma (MCL) is undergoing significant changes, particularly with the introduction of novel biologically targeted therapies in frontline treatment. These advancements offer new hope for patients, especially those with relapsed or refractory MCL, where options were previously limited.

Historically, older MCL patients have been treated with chemoimmunotherapy regimens like bendamustine and rituximab. However, these treatments often come with significant side effects due to their chemotherapeutic components. The emergence of chemotherapy-free combinations like BOVen (zanubrutinib [BRUKINSA], obinutuzumab [GAZYVA], and venetoclax [VENCLEXTA]) presents a less toxic and potentially more effective alternative for treating older patients with MCL.

In a poster presentation during EHA 2024, the BOVen combination therapy has shown promising results in the frontline treatment of TP53-mutant MCL. This combination has been observed to be effective and safe, offering a new potential standard-of-care for this patient group.

Key findings: 

• Overall Response Rate (ORR): 98%

• Complete Response (CR): 79%

• Partial Response (PR): 19%

• Progression-Free Survival (PFS):

• 2-year rate: 72%

• Median PFS not yet reached

• The trial included patients aged 65 or older or those with comorbidities preventing autologous stem cell transplantation.

• Common adverse effects included bruising, diarrhea, neutropenia, thrombocytopenia, COVID-19 infection, fatigue, nausea, infusion-related reactions, and anemia.

KOL insights

“The preliminary efficacy is promising with high ORR and high undetectable minimal residual disease [MRD] rates (at 10-5 sensitivity) by cycle 13; however, follow-up is limited.” – MD, United States

Conclusion 

These novel therapies, including CAR T-cell therapy and bispecific antibodies, represent a shift towards more personalized and targeted approaches to cancer treatment. They provide mechanisms to directly target cancer cells while sparing healthy cells, reducing overall toxicity and improving patient outcomes.

The evolving therapeutic landscape for MCL is marked by the integration of innovative treatments that offer efficacy and safety for patients who previously had limited options. The BOVen combination is at the forefront of this shift, heralding a new era in MCL management.