Closer to a Cure for Mantle Cell Lymphoma

Mantle Cell Lymphoma (MCL), as described in this issue of CURE®, has an interesting and inspiring story. It was one of the first cancers known to have a genetic abnormality-chromosomal translocation t(11;14).

This mutation causes an over expression of the protein cyclin D1, which drives cells to grow, ultimately become malignant and then multiply. However, until recent years, t(11;14) and other mutations were only used to diagnose MCL, not as a target in treating the disease. MCL was treated like most other lymphomas, with chemotherapy and steroids and then eventually Rituxan (rituximab).

Like many times with cancer, scientific discoveries broke the stalemate of MCL that had become refractory, meaning it stopped responding to treatment. Additional cancer promoters were discovered, including Bruton tyrosine kinase (BTK) — an enzyme that promotes cancer proliferation.

That eventually led to drugs that inhibited BTK to be tested — and effective in — refractory MCL. Continued study of the disease also found more targets, leading to other drugs like Venclexta (venetoclax). Most recently, Tecartux (brexucabtagene autoleucel), a genetically engineered T cell therapy was approved for MCL treatment. All the while, researchers are still studying cyclin D1 and the cell cycle pathways it controls, in a continued quest for more treatments for MCL.

Outcomes continue to improve for patients with MCL, as the disease has gone from being highly resistant and difficult to treat to one of the more manageable types of blood cancers, thanks to newer and intelligently designed drugs — many that are the fruits of basic science research.

This highlights the critical value of clinician expertise in diagnosis and treatment. In this day and age, we hope that telemedicine and simple awareness can bring these treatments to more patients who need them, improving outcomes and quality of life for all with the disease.

Editor’s Note from Dec. 21, 2023: The has been edited to update the comment about improved outcomes for patients with MCL from “one of the more curable types of blood cancers” to a blood cancer type that can go into remission.