Adverse Events for BTK Inhibitors and BCL2 Inhibitors in CLL

Opinion
Video

Expert perspectives on the toxicities seen with targeted therapies in chronic lymphocytic leukemia and how they’re mitigated and managed.

This is a video synopsis/summary of an Insights featuring: Nicole Lamanna, MD.

Dr. Lamanna reviews common side effects and adverse events of interest with Bruton tyrosine kinase (BTK) inhibitors like ibrutinib, acalabrutinib, and zanubrutinib and the B-cell lymphoma 2 (BCL2) inhibitor venetoclax used to treat chronic lymphocytic leukemia (CLL).

With BTK inhibitors, atrial fibrillation and hypertension require involving cardiologists and managing blood pressure. Patients need counseling on bleeding risk prior to procedures and how to mitigate diarrhea and arthralgia/myalgia if they occur. Headaches are more common specifically with acalabrutinib. Occasionally BTK inhibitors need dose reductions or holds for intolerable side effects.

With venetoclax, careful monitoring and management for tumor lysis syndrome is critical, especially early in therapy and in high risk patients who may require inpatient starts. When combined with CD20 antibodies, infusion reactions must also be monitored. Gastrointestinal side effects and cytopenias like neutropenia are more common with venetoclax versus BTK inhibitors.

Video synopsis is AI-generated and reviewed by OncLive® editorial staff.

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