Comparing BTK Inhibitors in Patients With B-Cell Malignancies

Ian W. Flinn, MD, PhD, director of lymphoma research and a principal investigator at Sarah Cannon Research Institute, and director of the Sarah Cannon Center for Blood Cancer at Tennessee Oncology and TriStar Centennial Medical Center, discusses the Bruton’s kinase (BTK) inhibitors available for patients with B-cell malignancies and how they compare.

There are many ongoing trials with zanubrutinib (Brukinsa) and other BTK inhibitors in the B-cell lymphoma landscape. Flinn says the biggest issue in these disease settings currently is deciding which BTK inhibitor is better to use for these patients. Head-to-head trials are looking at zanubrutinib with ibrutinib (Imbruvica) versus acalabrutinib (Calquence) with ibrutinib to get a better understanding of how the efficacy and adverse event profiles compare.

Many people think that these drugs are fairly similar in their efficacy, but because some patients have to come off treatment—most prominently with ibrutinib—that cuts into the efficacy because patients are no longer on therapy, according to Flinn. He thinks that may be where the differences are most evident for patients and will help physicians decide which BTK inhibitor is best to use depending on the patient.

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