First Line Therapy in Mantle Cell Lymphoma-The Role of BTKi in the Initial Treatment of Transplant-Eligible and -Ineligible Patients.

The development and implementation of new targeted and immunotherapeutic approaches in the treatment landscape of mantle cell lymphoma have already improved therapeutic options especially for refractory or relapsed disease. Regarding first-line therapy, treatment strategies including novel agents are under investigation. In transplant-eligible patients, a combined ibrutinib-containing immunochemotherapy induction followed by ASCT was shown to be superior compared to the chemotherapy regimen +/- ASCT. Thus, we consider the addition of ibrutinib to first-line therapy in younger MCL patients a new standard of care. For the group of older MCL patients ineligible for high-dose therapy and ASCT, several targeted therapy approaches have been investigated in different studies in combination with immunochemotherapies or as single agents +/- other targeted therapies with promising results. This review summarizes the current standard of care for first-line treatment of mantle cell lymphoma, highlighting the implementation of targeted treatment strategies, especially BTKi, in initial treatment strategies. Trial Registration: ClinicalTrials.gov identifier: NCT06482684.