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Opinion|Videos|July 29, 2024

BTKi Intolerance in Real-world Practice & Management Strategy

Author(s)Catherine C. Coombs, MD, Matthew S. Davids, MD, MMSc, Richardo D. Parrondo, MD

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.

Episodes in this series

5 KOLs are featured in this panel.

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

5 KOLs are featured in this panel.

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

5 KOLs are featured in this panel.

EP. 3 Frontline BTKi Selection

5 KOLs are featured in this panel.

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

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

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

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

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EP. 8 Navigating Treatment Approaches for R/R CLL

5 KOLs are featured in this panel.

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

5 KOLs are featured in this panel.

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

5 KOLs are featured in this panel.

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

5 KOLs are featured in this panel.

EP. 12 Approach to Hypertension Management With BTKi Treatment

5 KOLs are featured in this panel.

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

5 KOLs are featured in this panel.

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

A panel of 5 experts on CLL

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

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

A panel of 5 experts on CLL

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

A panel of 5 experts on CLL

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

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

A panel of 5 experts on CLL

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

A panel of 5 experts on CLL

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

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