Nemtabrutinib Shows Promise in Relapsed/Refractory Follicular Lymphoma

Wojciech Jurczak, MD, PhD, head of the department of oncology at Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw, Poland, ​​discusses nemtabrutinib, a Bruton’s tyrosine kinase (BTK) inhibitor currently undergoing development for the treatment of patients with follicular lymphoma.

Recent data presented at the American Society of Hematology 2024 Annual Meeting and Exposition highlighted nemtabrutinib monotherapy in heavily pretreated patients with follicular lymphoma, showing a 41% objective response rate (95% CI, 24-61), including 1 complete remission, 11 partial remissions, and 6 patients with stable disease.

Additional safety and efficacy results from the phase 2 BELLWAVE-003 study (NCT04728893) showed that when nemtabrutinib was given to patients with relapsed/refractory follicular lymphoma at the recommended phase 2 dose of 65 mg once daily, the median duration of response was 5.8 months (range, 1.5-not reached [NR]) with a median time to response of 2.8 months (range, 2.6-5.4). The median progression-free survival within the as-treated population was 5.5 months (95% CI, 2.8-NR), and the median OS was NR (95% CI, 10.4-NR), with a 6-month OS rate of 100%.

Looking at safety, any-grade adverse events (AEs) were seen in 31 (86%) patients. Most of these AEs included neutropenia (28%), decreased platelet count (22%), and anemia (19%). Grade 3 or 4 AEs were observed in 13 (36%) patients. The most common grade 3 or 4 AEs included decreased platelet count (8%), thrombocytopenia (8%), neutropenia (8%), and anemia (6%).

There was no atrial fibrillation or other arrhythmia seen in the study. One patient had a dose reduction due to an AE, and 3 patients discontinued treatment due to an AE. These 3 AEs that led to discontinuation were thrombocytopenia, drug-related toxicity, and urticaria. Moreover, there were no deaths linked with AEs reported in the trial.

Findings from this study underscore the potential of newer BTK inhibitors in challenging cases, offering hope for improved outcomes in advanced lymphoma therapy.