Dr D’Angelo on the Role BTK Inhibitors Play in PCNSL

“BTK inhibitors tick off a lot of boxes in managing [pathway, patient, and population problems] with PCNSL”.

Christopher R. D’Angelo, MD, an assistant professor in the Division of Hematology at the University of Nebraska Medical Center, discussed the current role of BTK inhibitors in the management of primary central nervous system lymphoma (PCNSL).

D’Angelo started by outlining his methodology when thinking about PCSNL, highlighting 3 key problem areas in PCNSL management that he believes must be addressed with research and novel treatment approaches. The first area he referred to as the pathway problem, which specifically focuses on the issues of identifying the molecular pathways that give rise to disease progression and persistence in PCNSL. Next, the health of patients with PCNSL is an concern when considering potential treatment avenues, D’Angelo underscored, noting that these patients could benefit more from well-tolerated therapies. Finally, the population problem is the third area in PCNSL that D’Angelo discussed, noting rarity of the disease requires adequate support is needed to drive research and improve patient outcomes.

Regarding BTK inhibitors, he explained that this class of agents is sufficient in managing each of the key problem areas he underscored. These inhibitors target the BTK pathway, which is connected to B-cell receptors and responsible for the persistence of PCSNL, he added. D’Angelo also emphasized the general safety profile of BTK inhibitors, highlighting the oral aspect of the treatment and the precision of later-generation agents that make them safe for patients with PCNSL. D’Angelo concluded by commenting on the support and widespread collaboration that comes with BTK inhibitors and clinical trials that evaluate them. Strong support and collaboration behind the investigation of BTK inhibitors could help elevate evidence behind the safety and efficacy of the these agents in PCNSL care, he noted.