BTKi Intolerance in Real-world Practice & Management Strategy

Author(s):

Catherine C. Coombs, MD,Matthew S. Davids, MD, MMSc

Key opinion leaders compare and contrast the most frequently observed causes of BTK inhibitor intolerance in clinical practice among patients treated with ibrutinib, acalabrutinib, or zanubrutinib.

EP: 1.Introducing the Expert Panel on CLL Treatment Updates Live at EHA 2024

EP: 2.Testing Practices and Role of High-risk Features to Decision Making in Newly Diagnosed CLL

EP: 3.Frontline BTKi Selection

EP: 4.Dr Parrondo’s Frontline CLL Treatment Approach for Pre-existing HTN and Afib

EP: 5.Dr Lamanna Reviews Study Data for 1L Doublet Therapy or Triplet Therapy

EP: 6.Dr Danilov Reviews EHA 2024 Data on the Role of 1L Triplet Therapy in CLL

EP: 7.EHA 2024 Review of Ongoing Trials Evaluating BCL2i/BTKi Combination Approaches

EP: 8.Navigating Treatment Approaches for R/R CLL

EP: 9.How Experts View MAIC Data That was Presented at EHA 2024

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EP: 10.BTKi Intolerance in Real-world Practice & Management Strategy

EP: 11.Applying EHA 2024 Data to Switching and Sequencing Treatments for CLL & Impact of Toxicities

EP: 12.Approach to Hypertension Management With BTKi Treatment

EP: 13.Dr Parrondo shares Approach to Managing BTKi Treatment-Related Afib

EP: 14.Navigating BTKi Resistance in CLL with Findings from ELEVATE-RR and ALPINE Studies: Sequencing Approach and Potential Role for Testing

EP: 15.Experts Review Pirtobrutinib Clinical Data and Share its Utilization in Practice

EP: 16.TRANSCEND CLL 004 Data Review and its Impact on Future Treatment Practices

EP: 17.EHA 2024 Updated Data on BTKi Degraders as Emerging Novel Agents in R/R CLL

EP: 18.Dr Parrando Reviews EHA 2024 Data on BTKi Degrader, BGB-16673

EP: 19.Dr Lamanna Shares Perspectives on EHA 2024 Data for the 2G BCL2 Inhibitors in R/R CLL

EP: 20.Review of Data from EHA 2024 of Emerging Novel Bispecific Antibodies

EP: 21.Clinical Pearls and Impacts to Practice from EHA 2024

What is the most common cause of BTKi intolerance you observe in the practice setting among patients receiving ibrutinib? Acalabrutinib or Zanubrutinib?
1. At what point during treatment does intolerance typically occur?Dr davids @39:30 – dose reduce...once per day...tyr to get back up to full dose and rechallenge with acala.
2. When may BTKi intolerance impact continuation of therapy and how do you manage these scenarios?
  1. Zanu in pts with acala/ibr intolerance – Shadman, et al. EHA 2023. Abs P633
  2. Acala in pts with ibr intolerance – Rogers, et al. Haematologica. 2021;106(9):2364-2373