Dr. Kallam on the Role of BTK and PI3K Inhibitors in CNS Lymphoma

Avyakta Kallam, MBBS, an assistant professor in the Department of Internal Medicine of the Division of Oncology & Hematology at the University of Nebraska Medical Center, discusses the role of BTK and PI3K inhibitors in the treatment of patients with central nervous system (CNS) lymphoma.

Because BTK inhibitors are capable of crossing the blood-brain barrier, they represent a strong therapeutic option for patients with CNS lymphoma, according to Kallam. These inhibitors can increase cell death and apoptosis; as such, they are increasingly being used in this disease, Kallam says.

However, these agents are mostly under exploration as second-line regimens—they have not yet been leveraged in the frontline setting, Kallam adds. Chemotherapy regimens with high-dose methotrexate serve as the current standard of care in the first-line setting for this population, Kallam explains. PI3K inhibitors are also currently under investigation in the second-line setting, Kallam adds.

Although research efforts are underway to potentially explore BTK inhibitors in the frontline, these efforts are largely in the early phases, according to Kallam. To date, ibrutinib (Imbruvica) is one of the agents that are most commonly utilized in this disease, Kallam concludes.