OnCo

Mantle cell lymphoma: lines of therapy

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4 standard-of-care settings across 3 lines and 3 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

LineAll comersFitUnfit / older
Advanced, first line·1·
Second line2··
Special situations··1

Advanced, first line

SubgroupSettingApproachProducts and trialsEvidence
FitFirst line, fit (<65-70)Rituximab + high-dose cytarabine-based induction (e.g. R-CHOP/R-DHAP or Nordic) with ibrutinib and 2 years ibrutinib maintenance; autologous transplant no longer adds benefit when ibrutinib is used (TRIANGLE).87

Second line

SubgroupSettingApproachProducts and trialsEvidence
All comersRelapsed, BTKi-naiveCovalent BTK inhibitor (acalabrutinib, zanubrutinib; ibrutinib ex-US) ± venetoclax (SYMPATICO).87
All comersRelapsed after BTKiBrexucabtagene or lisocabtagene CAR-T; pirtobrutinib; sonrotoclax (2026); allogeneic HSCT in selected patients; bispecific trials.82

Special situations

SubgroupSettingApproachProducts and trialsEvidence
Unfit / olderFirst line, older or unfitBendamustine-rituximab + acalabrutinib (ECHO, approved 2025) or BR alone with rituximab maintenance; R-CHOP alternative.87

Regimens in the library

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.