Review of Bruton tyrosine kinase inhibitors for the treatment of relapsed or refractory mantle cell lymphoma

• Published in: Current oncology (Toronto) Vol. 26; no. 2; pp. e233 - 240
• Main Authors: Owen, C, Berinstein, N L, Christofides, A, Sehn, L H
• Format: Journal Article
• Language: English
• Published: Canada Multimed Inc 01.04.2019
• Subjects: Agammaglobulinaemia Tyrosine Kinase - antagonists & inhibitors; Antineoplastic Agents - therapeutic use; Drug Resistance, Neoplasm; Humans; Lymphoma, Mantle-Cell - drug therapy; Neoplasm Recurrence, Local - drug therapy; Protein Kinase Inhibitors - therapeutic use; Recurrence; Review; mantle cell lymphoma; Bruton tyrosine kinase inhibitors; acalabrutinib
• ISSN: 1718-7729; 1198-0052; 1718-7729
• DOI: 10.3747/co.26.4345

Mantle cell lymphoma (mcl) is a rare subtype of aggressive B-cell non-Hodgkin lymphoma that remains incurable with standard therapy. Patients typically require multiple lines of therapy, and those with relapsed or refractory (r/r) disease have a very poor prognosis. The Bruton tyrosine kinase (btk) inhibitor ibrutinib has proven to be an effective agent for patients with r/r mcl. Although usually well tolerated, ibrutinib can be associated with unique toxicities, requiring discontinuation in some patients. Effective and well-tolerated alternatives to ibrutinib for patients with r/r mcl are therefore needed. Novel btk inhibitors such as acalabrutinib, zanubrutinib, and tirabrutinib are designed to improve on the safety and efficacy of first-generation btk inhibitors such as ibrutinib. Data from single-arm clinical trials suggest that, compared with ibrutinib, second-generation btk inhibitors have comparable efficacy and might have a more favourable toxicity profile. Those newer btk inhibitors might therefore provide a viable treatment option for patients with r/r mcl.