Dr. Leslie on Sequencing Zanubrutinib in MCL

A. Leslie, MD, lymphoma attending, John Theurer Cancer Center, discusses sequencing strategies with zanubrutinib (Brukinsa) in mantle cell lymphoma (MCL).

​In clinical trials, zanubrutinib is mainly used in patients who are intolerant of other BTK inhibitors, such as ibrutinib (Imbruvica) ​or acalabrutinib (Calquence), says Leslie. Notably, a number of clinical trials are currently ongoing in this space.

In clinical practice, zanubrutinib may be used for patients who are at risk of cardiovascular or bleeding events, Leslie adds. 

However, ​selecting between BTK inhibitors often depends on other factors as well, such as access, cost, and other medications the patient is receiving​, explains Leslie.

Although the burden of financial toxicity is not always considered during treatment selection, BTK inhibitors are expensive medications that may have substantial co-pays even after patient assistance programs, Leslie concludes.