Recent advances in the management of mantle cell lymphoma.
OBJECTIVE
This review will discuss the most recent literature regarding frontline therapy, treatment of patients not eligible for intensive chemotherapy, and novel agents for relapsed/refractory patients with mantle cell lymphoma (MCL).


RESULTS
Longer follow-up of previously studied intensive regimens still demonstrates encouraging results, but late relapses are still evident. Consolidation and maintenance strategies continue to be attractive options to be explored in this disease that is characterized by frequent relapses and short remissions. The combination of bendamustine-rituximab was demonstrated to be noninferior and less toxic to R-CHOP and should be considered the new standard of care for elderly patients. Multiple novel agents directed towards different molecular targets like BTK, mTOR, PI3K, HDAC, and BCL-2, involved in the pathogenesis of MCL have shown promising results.


CONCLUSIONS
Management of MCL still represents a challenge due to heterogeneity of the disease. As we approach the molecular era of oncology, future strategies should focus on combination of newer agents with known effective regimens to improve outcome.
aAuxilio Cancer Center bUniversity of Puerto Rico, School of Medicine, San Juan, Puerto Rico cUniversity of Texas, M. D. Anderson Cancer Center, Houston, Texas dUniversity of South Florida, Moffitt Cancer Center Tampa, Florida, USA.
Noridza
N
Rivera-Rodriguez
Fernando
F
Cabanillas
D000293:Adolescent; D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000069461:Bendamustine Hydrochloride; D002648:Child; D005260:Female; D006801:Humans; D000077269:Lenalidomide; D020522:Lymphoma, Mantle-Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality; D009588:Nitrogen Mustard Compounds / Q000008:administration & dosage; D018579:Patient Selection; D019869:Phosphatidylinositol 3-Kinases / Q000008:administration & dosage; D011379:Prognosis; D000069283:Rituximab; D016879:Salvage Therapy; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives; D016896:Treatment Outcome
D020533:Angiogenesis Inhibitors; D058846:Antibodies, Monoclonal, Murine-Derived; D009588:Nitrogen Mustard Compounds; D000069283:Rituximab; D013792:Thalidomide; D000069461:Bendamustine Hydrochloride; D019869:Phosphatidylinositol 3-Kinases; D000077269:Lenalidomide