Journal of Clinical Medicine Review Relapsed Mantle Cell Lymphoma: Current Management, Recent Progress, and Future Directions David A Bond 1,*, Peter Martin 2 and Kami J Maddocks 1 1 Division of Hematology, The Ohio State University, Columbus, OH 43210, USA;
[email protected] 2 Division of Hematology and Oncology, Weill Cornell Medical College, New York, NY 11021, USA;
[email protected] * Correspondence:
[email protected] Abstract: The increasing number of approved therapies for relapsed mantle cell lymphoma (MCL) provides patients effective treatment options, with increasing complexity in prioritization and se- quencing of these therapies. Chemo-immunotherapy remains widely used as frontline MCL treatment with multiple targeted therapies available for relapsed disease. The Bruton’s tyrosine kinase in- hibitors (BTKi) ibrutinib, acalabrutinib, and zanubrutinib achieve objective responses in the majority of patients as single agent therapy for relapsed MCL, but differ with regard to toxicity profile and dosing schedule. Lenalidomide and bortezomib are likewise approved for relapsed MCL and are active as monotherapy or in combination with other agents. Venetoclax has been used off-label for the treatment of relapsed and refractory MCL, however data are lacking regarding the efficacy of this approach particularly following BTKi treatment. Anti-CD19 chimeric antigen receptor T-cell (CAR-T) therapies have emerged as highly effective therapy for relapsed MCL, with the CAR-T treatment brexucabtagene autoleucel now approved for relapsed MCL. In this review the authors summarize evidence to date for currently approved MCL treatments for relapsed disease including Citation: Bond, D.A; Martin, P.; sequencing of therapies, and discuss future directions including combination treatment strategies Maddocks, K.J Relapsed Mantle Cell and new therapies under investigation.