BTK Inhibitors Improve Responses Relapsed/Refractory Mantle Cell Lymphoma

Andre Goy, MD, chief in the division of lymphoma, chairman and director at John Theurer Cancer Center, discusses the different BTK inhibitors as treatment of patients with relapsed/refractory mantle cell lymphoma.

What is interesting is this provides a new platform in the relapsed/refractory setting, says Goy. BTK inhibitors are inducing some durability of response. When looking at the long-term follow-up data for these agents, such as ibrutinib (Imbruvica), it is interesting to see that if a patient had 1 prior line of therapy, they had a very durable response with a median progression-free survival over 33 months compared with 8 months for 2 or more prior lines of therapy. They also saw that when a patient has a complete response, durability is over 5 years.

BTK inhibition has a bit of an inconvenience in terms of toxicity, particularly the off-target effects. Atrial fibrillation and risk of bleeding are higher with Ibrutinib compared with the other BTK inhibitors because they are more selective, particularly acalabrutinib (Calquence), says Goy. There is not much data for zanubrutinib (Brukinsa), but the same toxicity has been observed. However, Goy notes there was less atrial fibrillation and bleeding with zanubrutinib.

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