Expanding Treatment Options in Mantle Cell Lymphoma
At the 2026 LL&M Winter Symposium in Amelia Island, Florida, John Leonard, MD, Perlmutter Cancer Center, New York, New York, discusses recent advances in mantle cell lymphoma.
Dr Leonard reviews the evolving role of BTK inhibitors in both frontline and relapsed settings, as well as the diminishing use of autologous stem cell transplant in initial therapy, and highlights emerging options, including CAR T-cell therapy, next-generation BTK inhibitors, and novel targeted agents.
Transcript:
I’m John Leonard from the Perlmutter Cancer Center at NYU Langone Health. I’m here at the 2026 LL&M Winter Symposium, and it’s really great to be here– it’s an important meeting with a lot of great discussion.
My talk was focused on new developments in mantle cell lymphoma and I think we covered a number of different areas that are important for individuals taking care of patients with mantle cell lymphoma, as well as those doing research in the field. We have a lot of new studies that suggest the benefit of a BTK inhibitor as part of initial therapy.
One of the studies that we covered was the TRIANGLE regimen, another study that we covered was the ECHO regimen– those both include BTK inhibitors of different types in combination with chemotherapy, either more or less intensive chemotherapy, as initial treatment for mantle cell lymphoma. The takeaways there are that the BTK inhibitor improves progression-free survival, although it does not improve overall survival at this point in a meaningful way. Therefore, BTK inhibitors can be considered either as second-line therapy or as part of frontline therapy in mantle cell lymphoma.
Another key takeaway from recent presentations that we covered here was the diminishing role of autologous stem cell transplant and high-dose chemotherapy as part of initial therapy in mantle cell lymphoma. There are more and more data suggesting that there is really limited to no value of autologous transplant in first remission for mantle cell lymphoma, and that is something that has evolved more dramatically in recent years and is an important takeaway for the audience.
Another important aspect of upfront therapy is the use of BTK inhibitors in patients with TP53-mutated disease, that is a group of patients that does not do as well with chemotherapy alone and needs a BTK inhibitor–based approach as part of initial treatment.
Moving to the relapsed setting, there are lots of different options. As I mentioned, a number of patients continue to receive BTK inhibitors of different types—whether that’s acalabrutinib, zanubrutinib, or still in some cases ibrutinib—as second-line therapy, which remains an important strategy. We also have a number of new agents and options for patients with multiply relapsed disease, these include a newer BTK inhibitor, pirtobrutinib, we have data with both approved and investigational CAR T-cell therapies, and we have other strategies that are in clinical trials that are very exciting, including a new BCL2 inhibitor, sonrotoclax, new CAR T-cell constructs, and potentially bispecific antibodies, which may have a role in mantle cell lymphoma in the future.
It was great to cover these topics, there is a lot happening, and I think the good news for our patients is that we have more and more options for patients with mantle cell lymphoma. They are living longer, and it remains a very important area for physicians in practice to keep up with because it continues to be a rapidly evolving situation.
Source:
Leonard J. Current approaches in mantle cell lymphoma. Presented at Lymphoma, Leukemia & Myeloma Winter Symposium; January 30 - February 1, 2026. Amelia Island, Florida.
