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EHA 2025 | The current approach to managing TP53-mutated mantle cell lymphoma
In this interview, Christopher D’Angelo, MD, University of Nebraska Medical Center, Omaha, NE, comments on the optimal management of TP53-mutated mantle cell lymphoma (MCL), noting that standard chemotherapy approaches are ineffective and that novel therapies are a superior option for this patient population. Dr D’Angelo emphasizes the importance of sequencing to identify mutations and guide subsequent treatment decisions. In most patients, Dr D’Angelo favors the BOVen trial regimen (NCT03824483) if a suitable clinical trial is not available. This interview took place at the 30th Congress of the European Hematology Association (EHA) in Milan, Italy.
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Transcript
What we are recognizing with TP53-mutated mantle cell lymphoma is that standard chemotherapy approaches are not effective. So in my practice and at our center we move on to novel therapy pretty quickly. We are encouraged by the BOVen data which is obinutuzumab, venetoclax, and a BTK inhibitor...
What we are recognizing with TP53-mutated mantle cell lymphoma is that standard chemotherapy approaches are not effective. So in my practice and at our center we move on to novel therapy pretty quickly. We are encouraged by the BOVen data which is obinutuzumab, venetoclax, and a BTK inhibitor. Nowadays we’re usually using zanabrutinib with the BOVen regimen, and that tends to be what we are looking for when we are testing patients and treating patients for newly diagnosed TP53-mutated mantle cell lymphoma. All of those patients, I think, very important that you get sequencing on them, not just cytogenetics looking for a 17p deletion. We’re really looking for the mutations there, and it’s really one of the more important first steps in making sure that we’re ideally managing these patients. We’re not really transplanting TP53-mutated mantle cell lymphoma, especially with the newer data that’s coming out just in general on the use of transplanted mantle cell lymphoma. We tend to use BOVen more than TRIANGLE in this space. There might be an opportunity for that, but it wasn’t really as well reported in the TRIANGLE paper on who is TP53 mutated. Instead they’re looking at slightly different parameters of that. So for the most part, we’re using BOVen if there’s not a clinical trial option that’s available.
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Disclosures
Consulting: Abbvie, Beigene, ADC Therapeutics, Genmab, BMS; Research: BMS, Abbvie-Genmab, Beigene, Fate Therapeutics, Genentech, Curis Inc.
