Silkenstedt Elisabeth, Dreyling Martin
Department of Medicine III, Ludwig Maximilian University Hospital, Munich, Germany.
Blood. 2025 Feb 13;145(7):673-682. doi: 10.1182/blood.2023022353.
Mantle cell lymphoma (MCL) is a rare subtype of B-cell non-Hodgkin lymphoma that is clinically characterized by its heterogeneous behavior, with courses ranging from indolent to highly aggressive cases with limited prognosis. Targeted treatment alternatives in first-line and relapse settings are more and more shaping the therapeutic landscape of MCL. The development and implementation of new targeted and immunotherapeutic approaches have already improved outcomes for patients with MCL with refractory or relapsed disease. However, long-term prognosis is still limited, and patients with relapsed/refractory (R/R) disease, especially those failing Bruton tyrosine kinase (BTK) inhibitor treatment, usually have a dismal outcome. This review summarizes the current and emerging treatment options for R/R MCL, focusing on the implementation of combined targeted treatment strategies such as BTK inhibitors and BCL2 inhibitors, as well as immune-therapeutic approaches including chimeric antigen receptor T cells and bispecific antibodies.
套细胞淋巴瘤(MCL)是B细胞非霍奇金淋巴瘤的一种罕见亚型,其临床特征是行为异质性,病程从惰性到高度侵袭性不等,预后有限。一线和复发情况下的靶向治疗选择越来越多地塑造着MCL的治疗格局。新的靶向和免疫治疗方法的开发与应用已经改善了难治性或复发性MCL患者的预后。然而,长期预后仍然有限,复发/难治性(R/R)疾病患者,尤其是那些对布鲁顿酪氨酸激酶(BTK)抑制剂治疗无效的患者,通常预后不佳。本综述总结了R/R MCL目前和新兴的治疗选择,重点关注联合靶向治疗策略的应用,如BTK抑制剂和BCL2抑制剂,以及免疫治疗方法,包括嵌合抗原受体T细胞和双特异性抗体。