OBJECTIVES: This study aimed to give a general overview of the treatment pathway and unmet needs of Mantle Cell Lymphoma (MCL) in Portugal.

METHODS: Two interviews with Hematologists were conducted to ascertain the treatment pathway of MCL patients. Subsequently, a web-based survey was administered, in November 2022, to characterize the percentage of patients with MCL per step of the treatment pathway, including watch-and-wait and in-treatment according to patient fitness and line of treatment. The main therapeutic unmet needs were also assessed. All answers were self-reported and were based on the personal clinical experience of each Hematologist.

RESULTS: A total of 19 Hematologists, from distinct geographical regions answered the web-based survey. On average, each Hematologist diagnosed 5 new patients in the last 12 months (with an average age of 65 years) and has currently 5 patients in-treatment. Approximately 20% of diagnosed patients stay in watch-and-wait over one year, and 56% are considered fit for intensive therapy when initiating treatment. 1L therapy for these patients consists essentially of dose-intensified immunochemotherapy, followed by rituximab maintenance (45%) or autologous stem cell transplantation (51%). Only 1% and 9% of fit and unfit patients, respectively, are treated with targeted therapy in 1L. On average, 44% of patients are eligible for 2L treatment, of which only 20% are considered fit. In 2L, 44% and 53% of fit and unfit patients are treated with targeted therapy, respectively. The main identified unmet needs were related with cure, less adverse events, greater therapeutic efficacy and duration of response, lower treatment toxicity, more therapeutic alternatives, and exclusively oral therapies for 1L.

CONCLUSIONS: Information about the treatment of MCL in Portugal is very scarce. This exploratory study showed that immunochemotherapy is the most common treatment for MCL patients in 1L, with the lack of therapeutic alternatives and treatment toxicity pointed as the main therapeutic unmet needs.