ESMO Guideline for Mantle Cell Lymphoma

An Expert Interview With Martin Dreyling, MD, PhD

Martin H. Dreyling, MD, PhD; Linda Brookes, MSc

Disclosures

September 25, 2014

In This Article

Future Guidelines: Molecular Approaches Move Up Front

Medscape: Do you intend that the ESMO guideline should be updated regularly, as the NCCN guidelines are?

Prof Dreyling: We agreed that we will regularly update these guidelines, as it is the case for all ESMO guidelines for the different hematologic diseases. We hope to have another consensus meeting on malignant lymphoma next June at the 13th International Conference on Malignant Lymphoma in Lugano, Italy. However, I assume we will have to totally rewrite the guidelines every three years or so.

Medscape: What changes do you foresee in the coming three or so years that may directly impact the next guideline update?

Prof Dreyling: The ongoing phase 3 randomized trials in Europe will have a major impact. For example, one trial is evaluating BR with or without ibrutinib as first-line therapy in elderly patients with MCL.[27] Another, the MCL R2 Elderly trial, is investigating whether addition of lenalidomide to rituximab maintenance improves progression-free survival compared with standard rituximab maintenance after induction treatment consisting either of R-CHOP followed by rituximab/cytarabine/dexamethasone (R-HAD), or R-CHOP alone.[28]

We are also working on a trial that will be activated next year, the MCL Younger 2 trial, which will look at initial treatment of patients aged less than 65 years with an alternating regimen of R-DHAP and R-CHOP, with or without ibrutinib as induction therapy. On the basis of the study results, I strongly believe that molecular approaches will become standard of care in first-line treatment of MCL in the very near future.

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