Dr. Ruan Discusses BTK Inhibitors in MCL

Jia Ruan, MD, PhD, associate professor of clinical medicine, Weill Cornell Medicine/NewYork-Presbyterian Hospital, discusses BTK inhibitors for the treatment of patients with mantle cell lymphoma (MCL).

There are many novel agents that are coming into the market, creating more options for patients, says Ruan. There are effective agents with manageable side effects, such as the second-generation BTK inhibitor acalabrutinib (Calquence), the highlights of which were presented at the 2017 ASH Annual Meeting. There was a high response rate and complete response rate seen with acalabrutinib in patients with MCL.

Acalabrutinib is an oral agent that is taken twice daily and can be easily administered in the outpatient community setting. This agent provides an additional option to the previous BTK inhibitor ibrutinib (Imbruvica). Longer follow-up and better experience is needed to compare and contrast the effectiveness and side effects, in order to determine which group of patients would be best served by each of those agents.

MCL has traditionally been treated by chemotherapy, and generally tailored to young and fit patients, explains Ruan. At the 2017 ASH Annual Meeting, there was a discussion about maintenance rituximab (Rituxan) following autologous stem cell transplant. That extends previous research in terms of intensive regimens for young and fit patients. According to Ruan, additional approaches and options can provide benefits for patients who prefer to have high-intensity treatment with a finite course of time.