VIDEO: 'Productive last year' for mantle cell lymphoma treatment

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I think a pretty productive last year or two in mantle cell lymphoma treatment. Couple of noteworthy things, when we went to the ASH meeting in December, that's the American Society of Hematology meeting. The number one presentation at their plenary session was an important European study in mantle cell lymphomas called the triangle study. And this was a study that was looking at management of younger mantle cell lymphoma patients, looking at different first line treatment strategies. And what they were really testing in triangle was could you improve outcomes with the addition of a BTK inhibitor into like standard frontline immunochemotherapy? And the BTK inhibitor they picked was ibrutinib for this study. So the study had three arms. One arm was just kind of their standard immunochemotherapy followed by stem cell transplant followed by maintenance rituximab. So that's the control arm. And then arm B added ibrutinib to that control arm and that was given for two years post-transplant throughout the induction. And then two years post-transplant. And then arm C actually subtracted the stem cell transplant, kept the ibrutinib addition in there. And the arm that appears to have the best combination of efficacy and toxicity profile was that arm C, that third arm where the ibrutinib was added and the stem cell transplant was subtracted. So that is, you know, potentially an amazing advance for these patients because the treatment that they have to go through in that first year is pretty rough. It's six months of kind of rough chemotherapy and then the stem cell transplant's rough and it takes months to recover from that. So, if you could get the same outcomes without having to put them through the stem cell transplant, that would be a huge advantage for patients. Now the tricky part with that is ibrutinib is not approved for use in the frontline. And in fact, ibrutinib was withdrawn from the US market a couple of months ago because they didn't meet their objectives at a confirmatory trial. It only had accelerated approval. So, it's a little bit of an awkward time cuz we have this really exciting data but we kind of have no way to act on it right now. The data's pretty new, it's not published yet. So those of us in the field are still kind of grappling with this reality and trying to figure out how we wanna take advantage of this new knowledge. And what I think we're gonna need to do is repeat some studies using like a second generation BTK inhibitor like acalabrutinib or zanubrutinib or something like that and incorporate that into the first line. So, I think it's a big breakthrough that we're not quite able to take advantage of yet, but hopefully soon.