Dr. Goy on Comparing the Toxicity Profiles of BTK Inhibitors in MCL

Andre Goy, MD, MS, chief, Division of Lymphoma, chairman and director, John Theurer Cancer Center, compares the toxicity profiles of available BTK inhibitors in mantle cell lymphoma (MCL).

Currently, 3 BTK inhibitors—–ibrutinib (Imbruvica), acalabrutinib (Calquence), and zanubrutinib (Brukinsa)––are approved for the treatment of patients with MCL who progress on at least 1 line of therapy.

BTK inhibitors are associated with off-target toxicities, including atrial fibrillation and an increased risk of bleeding, says Goy. The risk of these events appears to be increased with ibrutinib compared with acalabrutinib and zanubrutinib; however, there have not been head-to-head trials with these agents.

Acalabrutinib and zanubrutinib are more selective BTK inhibitors, which could account for the lower risk of off-target toxicities with these agents versus ibrutinib, explains Goy. As such, these agents could lead to greater adherence to treatment.

Comparative studies with BTK inhibitors are ongoing in chronic lymphocytic leukemia, concludes Goy.