The current therapeutic scenario for relapsed mantle cell lymphoma

Purpose of reviewPatients with relapsing mantle cell lymphoma (MCL)
still represent a demanding challenge for the hematooncologist. The
dismal prognosis and the absence of generally accepted therapeutic
standards hamper the clinical management of such cases. Moreover,
the availability of many targeted approaches, in a field so far
missing efficient salvage regimens, challenges current therapeutic
algorithms in these patients.Recent findingsMolecular targeted
drugs provide unprecedented response rates in relapsed and even
chemorefractory MCL. Many phase II studies demonstrated impressive
antilymphoma activity of compounds such as bortezomib, lenalidomide
and temsirolimus, whereas ongoing phase III trials currently assess
the real world' benefit and the impact on survival, both alone and
in combination with chemotherapy or monoclonal antibodies.
Recently, the Bruton's tyrosine kinase inhibitor ibrutinib,
targeting the B-cell receptor cascade, showed impressive response
rates and will be soon available in phase III trials.SummaryIn the
present review we focus on the major therapeutic discoveries of the
last few years to offer a practical algorithm to select the
appropriate treatment in patients with relapsed MCL.