Dr Shadman on Zanubrutinib in Acalabrutinib-Intolerant Patients With B-cell Malignancies

Mazyar Shadman, MD, MPH, an associate professor in the Clinical Research Division at Fred Hutchinson Cancer Center, discusses the examination of zanubrutinib (Brukinsa) in patients with B-cell malignancies who were intolerant to acalabrutinib (Calquence).

The ongoing phase 2 BGB-3111-215 trial (NCT04116437) is evaluating the use of zanubrutinib in patients with previously treated B-cell lymphoma who were intolerant to prior treatment with a BTK inhibitor, such as ibrutinib (Imbruvica) or acalabrutinib. Data were presented at the 2022 ASH Annual Meeting from the cohort of patients treated with zanubrutinib who were intolerant to prior treatment with acalabrutinib.

Findings showed that patients experienced a median treatment exposure time of 7.6 months with zanubrutinib compared with 4.6 months for acalabrutinib, Shadman explains. Although patients experienced a longer time on treatment with zanubrutinib, the majority of them did not experience a recurrence of adverse effects (AEs) that led to intolerance of acalabrutinib, Shadman notes.

Additionally, no high-grade AEs were observed for treatment with zanubrutinib vs acalabrutinib, Shadman continues. Notably, the efficacy and disease control rate were promising, Shadman adds. No patients who experienced disease progression on prior acalabrutinib were included in the trial, meaning patients could continue to experience an efficacy benefit with zanubrutinib, Shadman concludes.