Dr. Martin on Selecting Among FDA-Approved BTK Inhibitors in MCL

Peter Martin, MD, chief of the Lymphoma Program at the Meyer Cancer Center and an associate professor of medicine at Weill Cornell Medicine, discusses selecting among BTK inhibitors for the treatment of patients with mantle cell lymphoma (MCL).

Currently, 3 FDA-approved BTK inhibitors are available for the treatment of patients with MCL: ibrutinib (Imbruvica), acalabrutinib (Calquence), and zanubrutinib (Brukinsa). Differences between the agents are subtle and must be interpreted carefully based on relatively small phase 2 trials with approximately 100 patients, Martin notes. Despite differences in response rate and progression-free survival, it is currently difficult to determine whether 1 agent is superior to another, according to Martin.

Based on data from randomized trials done in other malignancies, ibrutinib and zanubrutinib have demonstrated similar efficacy. Moreover, a recent study in chronic lymphocytic leukemia indicated that acalabrutinib is noninferior to ibrutinib, although more data need to read out, Martin explains. Although these drugs have similarities in terms of efficacy when used as single agents, subtle differences between them can help guide decision making, Martin concludes.