Dr. Jain on the Role of BTK Inhibitors in MCL

Preetesh Jain, MD, PhD, clinical fellow in medical oncology at The University of Texas MD Anderson Cancer Center, discusses the role of BTK inhibitors in mantle cell lymphoma (MCL).

Atrial fibrillation is a common adverse effect observed with BTK inhibitors in patients with MCL. Specifically, ibrutinib (Imbruvica) has demonstrated an increased risk of atrial fibrillation. This was not only demonstrated in several MCL studies, but in trials evaluating patients with chronic lymphocytic leukemia and Waldenström macroglobulinemia as well. Notably, this is in result of the off-target effects associated with ibrutinib, Jain says.

Further, similar to the enzymes inhibited by ibrutinib, cardiomyocytes also harbor TEC kinase. However, other approved BTK inhibitors, such as acalabrutinib (Calquence) and zanubrutinib (Brukinsa), can be administered instead of ibrutinib for patients with MCL. Other investigational BTK inhibitors, such as LOXO-305, have demonstrated encouraging results and could potentially emerge as exciting advancements in the MCL treatment paradigm, Jain concludes.