NCCN Guidelines for Patients® | Mantle Cell Lymphoma

30 NCCN Guidelines for Patients ® : Mantle Cell Lymphoma, 2017 3 Overview of cancer treatments Targeted therapy Targeted therapy Targeted therapy is a class of drugs. These drugs stop the action of molecules that help cancer cells grow. They are less likely to harm normal cells than chemotherapy. Targeted therapy for mantle cell lymphoma uses kinase or BCL-2 inhibitors. Ibrutinib Ibrutinib is sold as Imbruvica ® . It is a kinase inhibitor. Kinases are molecules that move chemicals, called phosphates, from one molecule to another. Kinase inhibitors stop the phosphate from being moved. Ibrutinib stops a kinase called BTK ( B ruton’s t yrosine ki nase). This kinase is found inside of B-cells. It helps cells grow and survive. Ibrutinib slows down mantle cell lymphoma. It works by causing cell death. It also stops the cells from quickly making new cells. Third, it stops the cells from moving into your bone and marrow. Ibrutinib is made in pill form. It is taken once a day around the same time. Your doctor will tell you how many pills you need for your dose. Ask your treatment team for a full list of side effects of ibrutinib. Some common side effects are fatigue, diarrhea, muscle and bone pain, bruising, bleeding, nausea, and rash. Blood counts are often low when taking this medicine. However, there may be a short- lived increase in white blood cells. Your doctor will assess for serious but uncommon side effects. These include heart and kidney problems. You may develop serious bleeding and infections. Ibrutinib may increase your chances for other cancers. Venetoclax Venetoclax is sold as Venclexta™. It is a BCL-2 inhibitor. BCL-2 is a protein inside of B-cells that helps prevent cell death. In some non-Hodgkin lymphomas, there is a large amount of BCL-2. BCL-2 inhibitors attach to BCL-2 and stop them from working. Thus, the lymphoma cells are able to die. Venetoclax is made in pill form. It is taken once a day with food and water. Your doctor will tell you how many pills you need for your dose. Ask your treatment team for a full list of side effects of venetoclax. Some common side effects are fatigue, diarrhea, nausea, and lung infection. Blood counts are often low. Your doctor will assess for serious but uncommon side effects. Venetoclax may cause TLS. Supportive care Supportive care doesn’t aim to treat cancer but aims to improve quality of life. It is also called palliative care. It can address many needs. One example is treatment for physical and emotional symptoms. Supportive care can also help with treatment decisions as you may have more than one option. It can also help with coordination of care between health providers. Talk with your treatment team to plan the best supportive care for you.

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