Carfilzomib + Lenalidomide and Dexamethasone for BTK Inhibitors Relapsed-refractory or Intolerant MCL

Inclusion criteria Patient has a confirmed diagnosis of MCL according to the WHO 2017 classification; * Previous treatment with BTKi monotherapy or BTKi containing regimens with R/R disease; and/or patients who discontinued BTKi monotherapy or BTKi containing regimens for adverse events and have active disease necessitating treatment; * Previous treatment with Lenalidomide is accepted if patient resulted responsive and interrupted Lenalidomide at least 12 months before enrollment to this study; * Patient age is ≥ 18 \< 80 years; * Patient has an Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 2; * Understands and voluntarily signs an informed consent form; * Able to adhere to the study visit schedule and other protocol requirements; Patient has at least one site of measurable nodal disease at baseline ≥ 2.0 cm in the longest transverse diameter as determined by CT scan (MRI is allowed only if CT scan cannot be performed). Note: Patients with bone marrow involvement are eligible; * Adequate hematological counts: ANC \> 1.5 x 109/L and platelet count \> 75 x 109/L unless due to bone marrow involvement by MCL; * Conjugated bilirubin up to 2 x ULN unless due to liver involvement by MCL; * Alkaline phosphatase and transaminases up to 2 x ULN unless due to liver involvement by MCL; * Creatinine clearance ≥ 30 ml/min; a dose reduction of Lenalidomide for patients with creatinine clearance ≥ 30 mL/min but \< 50 mL/min is planned; * Patient has the ability to swallo…