Journal: Cancer
This consensus conference article summarizes expert recommendations for contemporary management of mantle cell lymphoma (MCL), chronic lymphocytic leukemia (CLL), and diffuse large B‑cell lymphoma (DLBCL), developed via a modified Delphi process to guide care where evidence is limited or evolving.
Key points:
- Mantle Cell Lymphoma (MCL)
- Routine assessment for high‑risk features is emphasized to guide intensity and choice of therapy.
- For TP53‑aberrant disease, the panel supports use of the BOVen regimen (zanubrutinib, obinutuzumab, venetoclax).
- Chimeric antigen receptor (CAR) T‑cell therapy is recommended for patients whose MCL is refractory to covalent Bruton tyrosine kinase (BTK) inhibitors.
- Chronic Lymphocytic Leukemia (CLL)
- For younger and fit patients, time‑limited treatment strategies should be considered, reflecting improved efficacy and tolerability of novel agents.
- A “watch and wait” approach remains appropriate for asymptomatic patients, despite the availability of more active and safer therapies.
- Diffuse Large B‑Cell Lymphoma (DLBCL)
- The article underscores ongoing challenges in treatment sequencing amid multiple active therapies.
- Circulating tumor DNA (ctDNA) and minimal residual disease (MRD) testing are highlighted as emerging tools to monitor disease status and progression, though optimal use is still being defined.
Overall, the consensus stresses individualized therapy, rational integration of novel agents and cellular therapies, and the critical need for further research to fill evidence gaps and optimize outcomes across these lymphoma subtypes.