title: Novel targeted therapies for mantle cell lymphoma.
abstract: Mantle cell lymphoma (MCL) is an aggressive B-cell malignancy characterized by short median survival despite intensive therapies. The clinical behavior of MCL may be due to the complex pathophysiology of the disease which includes its genetic hallmark, the chromosomal translocation t(11;14) resulting in aberrant expression of cyclin D1, alteration in the DNA damage response, and constitutive activation of key anti-apoptotic pathways such as phosphatidyl-inositol 3-kinase (PI3K)/Akt and nuclear factor-kB (NF-kB). Collectively, these changes result in cell cycle dysregulation and give rise to profound genetic instability. Given this complex pathophysiology, the limited number of options for patients with relapsed/refractory MCL, and the difficulty in achieving long-lasting remissions with conventional approaches, it is essential to explore new treatment options targeting the numerous dysregulated pathways that are operable in MCL. We have recently reported that milatuzumab, a fully humanized anti-CD74 monoclonal antibody (mAb), in combination with anti-CD20 mAbs has significant preclinical and clinical activity in MCL. Here we discuss these results, provide additional insights into milatuzumab-mediated MCL cell death, and report preliminary data on the activity of other targeted biologic agents including PCI-32765 and CAL-101 currently undergoing evaluation at our institution and others.
authors.affiliation: Division of Hematology, Department of Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, USA.
authors.forename: Lapo
authors.initials: L
authors.lastname: Alinari
authors.forename: Beth
authors.initials: B
authors.lastname: Christian
authors.forename: Robert A
authors.initials: RA
authors.lastname: Baiocchi
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000494:pharmacology* / Q000627:therapeutic use; D018951:Antigens, CD20 / Q000276:immunology; D000944:Antigens, Differentiation, B-Lymphocyte / Q000276:immunology; D001402:B-Lymphocytes / Q000473:pathology; D002453:Cell Cycle / Q000502:physiology; D002986:Clinical Trials as Topic; D019938:Cyclin D1 / Q000378:metabolism; D004260:DNA Repair; D005260:Female; D000949:Histocompatibility Antigens Class II / Q000276:immunology; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy; D016328:NF-kappa B / Q000378:metabolism; D019869:Phosphatidylinositol 3-Kinases / Q000378:metabolism; D010880:Piperidines; D051057:Proto-Oncogene Proteins c-akt / Q000378:metabolism; D011687:Purines / Q000494:pharmacology; D011720:Pyrazoles / Q000494:pharmacology; D011743:Pyrimidines / Q000494:pharmacology; D052999:Quinazolinones / Q000494:pharmacology; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors; D014178:Translocation, Genetic
chemical_list: D000225:Adenine; D061067:Antibodies, Monoclonal, Humanized; D018951:Antigens, CD20; D000944:Antigens, Differentiation, B-Lymphocyte; D019938:Cyclin D1; D000949:Histocompatibility Antigens Class II; D016328:NF-kappa B; D019869:Phosphatidylinositol 3-Kinases; D010880:Piperidines; D051057:Proto-Oncogene Proteins c-akt; D011687:Purines; D011720:Pyrazoles; D011743:Pyrimidines; D052999:Quinazolinones; D058570:TOR Serine-Threonine Kinases; C045084:invariant chain; C551803:ibrutinib; C540932:milatuzumab; C546842:MTOR protein, human; C552946:idelalisib