Role of ibrutinib in first-line treatment of mantle cell lymphoma in younger patients

High-dose cytarabine-containing immunochemotherapy followed by autologous stem cell transplantation and rituximab maintenance is the current standard of care for younger (up to 65 years) patients with mantle cell lymphoma (MCL). The BTK-inhibitor ibrutinib has shown promising efficacy in relapsed and previously untreated MCL in older patients. The European phase 3 TRANGLE trial found that among younger patients with mantle cell lymphoma, the addition of ibrutinib to standard treatment during induction and as maintenance with or without autologous stem cell transplantation showed strong efficacy with acceptable toxicity. The authors conclude that these results support the use of ibrutinib in first-line treatment of younger MCL patients.