Dr. Leslie on the Role of BTK Inhibitors in Relapsed/Refractory MCL

Lori A. Leslie, MD, lymphoma attending, John Theurer Cancer Center, discusses the role of BTK inhibitors in relapsed/refractory mantle cell lymphoma (MCL).

BTK inhibitors have had a significant impact on the treatment of patients with relapsed/refractory MCL, says Leslie. Ibrutinib (Imbruvica), acalabrutinib (Calquence), and zanubrutinib (Brukinsa) are currently approved in this setting.

In the absence of comparative data, toxicity, dosing, and potential drug-drug interactions may shed light on the optimal BTK inhibitor for each individual patient, Leslie says. For example, acalabrutinib and zanubrutinib seem to have a lower risk of cardiac or bleeding toxicities compared with ibrutinib.

Dosing strategies also differ, says Leslie. Ibrutinib is given once daily, acalabrutinib is given twice daily, and zanubrutinib may be given once or twice daily. Additionally, as opposed to acalabrutinib, zanubrutinib may be given with a proton pump inhibitor, concludes Leslie.