Dr. Burke on Current FDA Indications for BTK Inhibitors in B-Cell Malignancies

John M. Burke, MD, associate chair of the Hematology Research Program for US Oncology and medical oncologist and hematologist at Rocky Mountain Cancer Centers, discusses current indications for BTK inhibitors in B-cell malignancies.

There are currently 3 BTK inhibitors approved within B-cell malignancies, says Burke.

In chronic lymphocytic leukemia (CLL), ibrutinib (Imbruvica) is approved in the frontline and relapsed/refractory settings with or without an anti-CD20 antibody such as rituximab (Rituxan) or obinutuzumab (Gazyva). Acalabrutinib (Calquence) is also approved in the frontline and relapsed/refractory settings for patients with CLL. Although zanubrutinib (Brukinsa) is not approved in CLL, data regarding the agent’s utility in this space are emerging.

All 3 agents are approved for use in relapsed/refractory mantle cell lymphoma.

In marginal zone lymphoma, ibrutinib is approved in the relapsed/refractory setting.

Ibrutinib plus rituximab received FDA approval in Waldenström macroglobulinemia. Additionally, data regarding acalabrutinib and zanubrutinib suggest that both agents have utility in this patient population.