{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:52:15Z","timestamp":1787028735066,"version":"build-2736575974"},"reference-count":81,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Mantle cell lymphoma (MCL) is a rare mature B-cell non-Hodgkin lymphoma (B-NHL) with historically poor outcomes. Virtually all patients will eventually experience refractory or relapsed (R\/R) disease, with a virulent course of resistance and serial relapses, making treatment challenging. The available therapies for R\/R MCL are not curative with conventional therapy, their goal being to palliate and prolong survival. A variety of agents approved for R\/R MCL, including Bruton\u2019s tyrosine kinase inhibitors (BTKi), changed the treatment landscape of R\/R MCL. In the pre-BTKi era, the median progression-free survival (PFS) in R\/R disease was 4\u20139 months. With the introduction of ibrutinib, the median PFS improved to 13\u201314.6 months. Despite these impressive results, the duration of response is limited, and resistance to BTKi inevitably develops in a subset of patients. Outcomes after progression on BTKi are extremely poor, with a median overall survival (OS) of 6 to 10 months. Certain therapies, such as chimeric antigen receptor (CAR) T cells, have shown promising results after BTKi failure. The preferred combination and sequencing of therapies beyond BTKi remain unestablished and are currently being investigated. In this review, we describe the current evidence for the available treatment of R\/R MCL after progression on BTKi.<\/jats:p>","DOI":"10.3390\/jpm12030376","type":"journal-article","created":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T08:17:03Z","timestamp":1646122623000},"page":"376","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Relapsed\/Refractory Mantle Cell Lymphoma: Beyond BTK Inhibitors"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5105-0564","authenticated-orcid":false,"given":"Madelyn","family":"Burkart","sequence":"first","affiliation":[{"name":"Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA"},{"name":"Division of Hematology\/Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem","family":"Karmali","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"191","DOI":"10.14694\/EdBook_AM.2014.34.191","article-title":"European Mantle Cell Lymphoma Network Mantle cell lymphoma: Biology, clinical presentation, and therapeutic approaches","volume":"34","author":"Dreyling","year":"2014","journal-title":"Am. Soc. Clin. Oncol. Educ. 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