Dr. Martin on the Utility of CAR T-Cell Therapy in High-Risk MCL

Peter Martin, MD, chief of the Lymphoma Program at the Meyer Cancer Center and an associate professor of medicine at Weill Cornell Medicine, discusses selecting treatment for patients with high-risk mantle cell lymphoma (MCL).

This patient population does not do well with chemotherapy or targeted therapy, Martin says. Some data have indicated that CAR T-cell therapies have demonstrated activity in patients with blastoid disease, although more time is needed to understand how these products may best be utilized. In diffuse large B-cell lymphoma, CAR T cells are being underutilized relevant to their potential benefit; this may also be true for MCL, Martin explains.

When patients with MCL begin progressing after multiple lines of therapy and BTK inhibitors, the progression can be so rapid that they may not live long enough to receive CAR T-cell therapy, Martin says. As such, it is important to consider when this modality should be used in this patient population, according to Martin. 

If a patient has an aggressive lymphoma with short prior responses to therapy, blastoid histology, or high Ki-67 when starting treatment with a BTK inhibitor, it is important to consider that responses may be transient or suboptimal, Martin notes.

Additionally, CAR T cells should be manufactured when treatment is beginning to minimize any delays in subsequent treatments, Martin concludes.