Global Perspectives on BTK Inhibition in Primary CNS Lymphoma: Real-World Experience from Japan and Taiwan

This program explores the evolving treatment landscape for primary CNS lymphoma (PCNSL), with a focus on the clinical rationale, real-world experience, and emerging role of Bruton tyrosine kinase (BTK) inhibition. Dr. Lakshmi Nayak moderates a discussion with Dr. Christian Grommes, Dr. Motoo Nagane, and Dr. Jerome Cheng, bringing together perspectives from the United States, Japan, and Taiwan. The discussion reviews the biological features of PCNSL that support BTK inhibition, including frequent alterations affecting the B-cell receptor signaling pathway, as well as the challenges of treating disease within the central nervous system. Faculty discuss the evolution of BTK inhibitors, clinical trial findings, CNS penetration, treatment selection, response and durability, and practical management of adverse events. Dr. Nagane and Dr. Cheng provide insights from clinical practice in Japan and Taiwan, where terabrutinib is approved for relapsed/refractory PCNSL. The faculty also consider opportunities for BTK inhibitors in combination and earlier-line settings, while highlighting remaining questions regarding durability and long-term disease control. The program is intended to provide an international perspective on the role of BTK inhibition in PCNSL.