Dr. Hill on the Safety Profiles of BTK Inhibitors in MCL

Brian T. Hill, MD, PhD, director of the Lymphoid Malignancies Program and staff physician at Taussig Cancer Institute, as well as an assistant professor of hematology and oncology at the Cleveland Clinic, discusses ​the safety profiles of BTK inhibitors in mantle cell lymphoma (MCL).

​Currently, the BTK inhibitors zanubrutinib (Brukinsa), acalabrutinib (Calquence), and ibrutinib (Imbruvica) ​are approved for the treatment of patients with MCL ​who have received at least 1 prior therapy.

BTK inhibitor​s can elicit bleeding and bruising as a class-specific adverse effect (AE), says Hill. Moreover, a patient may experience gastrointestinal toxicities, such as diarrhea, ​with BTK inhibitors; however, these ​AEs tend to be self-limiting, Hill says. ​More specifically, arthralgia is commonly reported in patients who receive ibrutinib; atrial fibrillation is also reported in about 5% to 10% of patients ​on ibrutinib.

However, less cases of atrial fibrillation ​are reported in patients who receive acalabrutinib orzanubrutinib. In addition, mild ​to severe headaches can be observed with acalabrutinib. Notably, the AEs ​uniquely associated with zanubrutinib are less established; however, further evaluation of the agent may lend additional insight ​into its specific safety profile in the future, Hill concludes.