Prognostic Biomarkers in MCL: Insights from the SHINE Trial on the impact of MCL35 score and TP53 Mutation Status

• MCL35 assay robustly categorizes untreated MCL, revealing key biological variations among older patients.

• Within MCL35 risk categories, adding ibrutinib to BR did not markedly improve progression-free survival.

The MCL35 gene expression assay encompasses key risk features and stratified elderly MCL patients using routine biopsies. In the SHINE trial, high-risk patients had poor outcomes despite adding ibrutinib to bendamustine-rituximab, highlighting urgent need for novel strategies in high-risk MCL.