aAuxilio Cancer Center bUniversity of Puerto Rico, School of Medicine, San Juan, Puerto Rico cUniversity of Texas, M. D. Anderson Cancer Center, Houston, Texas dUniversity of South Florida, Moffitt Cancer Center Tampa, Florida, USA.
Curr Opin Oncol. 2013 Nov;25(6):716-21. doi: 10.1097/CCO.0000000000000010.
This review will discuss the most recent literature regarding frontline therapy, treatment of patients not eligible for intensive chemotherapy, and novel agents for relapsed/refractory patients with mantle cell lymphoma (MCL).
Longer follow-up of previously studied intensive regimens still demonstrates encouraging results, but late relapses are still evident. Consolidation and maintenance strategies continue to be attractive options to be explored in this disease that is characterized by frequent relapses and short remissions. The combination of bendamustine-rituximab was demonstrated to be noninferior and less toxic to R-CHOP and should be considered the new standard of care for elderly patients. Multiple novel agents directed towards different molecular targets like BTK, mTOR, PI3K, HDAC, and BCL-2, involved in the pathogenesis of MCL have shown promising results.
Management of MCL still represents a challenge due to heterogeneity of the disease. As we approach the molecular era of oncology, future strategies should focus on combination of newer agents with known effective regimens to improve outcome.
本文将讨论关于套细胞淋巴瘤(MCL)一线治疗、不适合强化化疗患者的治疗以及复发/难治性患者新药物的最新文献。
对先前研究的强化方案进行更长时间的随访仍然显示出令人鼓舞的结果,但仍存在晚期复发的情况。巩固和维持策略仍然是探索这种以频繁复发和短暂缓解为特征的疾病的有吸引力的选择。与 R-CHOP 相比,苯达莫司汀联合利妥昔单抗被证明具有非劣效性且毒性更小,应被视为老年患者的新标准治疗方案。针对 BTK、mTOR、PI3K、HDAC 和 BCL-2 等不同分子靶点的多种新型药物,它们在 MCL 的发病机制中发挥了作用,显示出了很好的效果。
由于疾病的异质性,MCL 的治疗仍然是一个挑战。随着我们进入肿瘤学的分子时代,未来的策略应侧重于将新的药物与已知有效的方案联合使用,以改善治疗效果。