Dr. Goy Discusses BTK Inhibitors in MCL

Andre Goy, MD, chairman and director, chief of Lymphoma, and director of Clinical and Translational Cancer Research at John Theurer Cancer Center, discusses the role of Bruton’s tyrosine kinase (BTK) inhibitors for the treatment of patients with mantle cell lymphoma (MCL).

This is an exciting time in MCL, as there continues to be more approved options for patients, explains Goy. Ibrutinib (Imbruvica) is associated with a response rate of 67% with a complete response (CR) rate of 40% after 1 year of treatment. The median duration of response is 17 months, and the long-term follow-up of 3 years showed that patients experienced a beneficial progression-free survival (PFS). However, there are some side effects, even though it is a well-tolerated drug overall, explains Goy. Around 6% to 7% of patients experience side effects when treated with ibrutinib based off of data from clinical trials. Overall, the toxicity gets better over time, Goy says.

Acalabrutinib (Calquence) is a BTK inhibitor that was approved by the FDA in October 2017 for patients with MCL following at least 1 prior therapy. The trial that led to the approval, ACE-LY-004, showed an investigator-assessed objective response rate of 81% with acalabrutinib (95% CI, 73%-87%). The complete response (CR) rate with acalabrutinib was 40% and the partial response rate was 41%. It is too early to report the median duration of response, but there were no cardiac toxicities, says Goy. Acalabrutinib may offer an alternative to ibrutinib, Goy adds.