Overarching Themes in MCL at ASH 2025

In this interview, Michael Wang, MD, reflects on a central theme emerging from research in mantle cell lymphoma (MCL) at ASH 2025: the evolution of MCL treatment from chemotherapy to targeted agents, cellular therapies, and immune-based approaches such as T-cell engagers. Rather than replacing earlier strategies, each new generation has expanded the therapeutic arsenal, delivering higher efficacy and improved tolerability. Wang emphasizes that even “best-in-class” agents are rapidly followed by next-generation drugs, including newer BCL2 inhibitors and BTK inhibitors with both covalent and noncovalent properties, often demonstrating even higher response rates than their predecessors.

He notes that the field is also benefiting from parallel advances in cellular therapy and bispecific antibodies, with increasingly effective and better-tolerated CAR T-cell products and T-cell engagers such as glofitamab and epcoritamab. Together, these developments underscore how rapidly the MCL landscape continues to expand, offering clinicians multiple highly active options across disease settings.

Wang highlights minimal residual disease (MRD) as another major focus at ASH 2025. While methodologies vary, MRD assessment across studies consistently predicts longer progression-free survival, duration of response, and overall survival. He argues that MRD monitoring has matured to the point where it should routinely inform clinical decision-making. In his own practice, rising MRD levels prompt early intervention with relatively simple therapies, often reversing molecular relapse before clinical progression.

Maintenance therapy also emerged as a critical driver of improved outcomes. Wang references data from studies such as LyMa, ECHO, and TRIANGLE, which collectively demonstrate that intensified or dual-agent maintenance can significantly improve progression-free and overall survival and, in some cases, eliminate the need for autologous stem cell transplantation. Building on this evidence, Wang describes his experience using prolonged, multi-agent maintenance following deep remission, including triple maintenance approaches that have thus far yielded no relapses even among high-risk patients.

Wang concludes that integrating novel therapies, MRD-guided management, and optimized maintenance strategies is transforming MCL into a disease increasingly defined by durable, chemotherapy-free control.