How do you approach front line treatment for TP53 mutated mantle cell lymphoma?

Topics: Hematologic Malignancies • Medical Oncology • Bone Marrow Transplant • Lymphoma • Hematology

Since some prior studies (eg. Eskelund et al. Blood 2017 130:1903-10.) have shown intensive chemoimmunotherapy does not overcome the adverse prognosis associated with TP53 mutation, are novel or targeted therapies favored at this time?

Is ASCT +/- post-transplant maintenance therapy favored in young, fit patients?

Answer from: Medical Oncologist at Academic Institution

For patients with TP53 mutations based on the information presented by Eskelund et al. and previous experience. Given the knowledge that the mutation is a dominant negative which eliminates and functional activity of the tumor suppressor it stands to reason that an durable response wi...

Answer from: Medical Oncologist at Academic Institution

Both R2 and I+R (or acala+R) are reasonable front-line approaches. Both approaches are tougher in those with proliferative bulky nodal disease (ki67>50%). We still can get responses, but is less common, and particularly for I+R, remissions tend to be shorter. If in this si...

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