Dr. Martin on Potential Combination Strategies With BTK Inhibitors in MCL

Peter Martin, MD, chief, the Lymphoma Program, Meyer Cancer Center, associate professor of medicine, Weill Cornell Medicine, discusses potential combination regimens with BTK inhibitors in mantle cell lymphoma (MCL).

BTK inhibitors have the potential to be combined easily with multiple agents in MCL, says Martin. For example, promising data from the phase 2 PHILEMON trial with ibrutinib (Imbruvica) plus lenalidomide (Revlimid) and rituximab (Rituxan) were presented during the 2020 ASH Annual Meeting and Exposition. The triplet regimen demonstrated promising clinical activity and a good safety profile in patients with high-risk relapsed/refractory MCL. Additionally, ibrutinib in combination with venetoclax (Venclexta) is being evaluated in the ongoing, randomized phase 3 SYMPATICO trial (NCT03112174) in patients with MCL, explains Martin. An additional ongoing study is investigating ibrutinib in combination with ixazomib (Ninlaro; NCT03323151) in relapsed/refractory MCL.

Finally, the CDK4/6 inhibitor palbociclib (Ibrance) in combination with ibrutinib demonstrated early efficacy signals in a phase 1 clinical trial (NCT02159755) for patients with previously treated MCL, says Martin. Moreover, palbociclib appears to sensitize MCL cells for cell death with BTK inhibitors, Martin adds.

Other potential combination strategies include BTK inhibitors plus PI3K inhibitors or checkpoint inhibitors, among others, concludes Martin.