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Fitting Zanubrutinib into the Treatment Landscape for Mantle Cell Lymphoma

Michael Wang, MD
Published Online:4:05 PM, Fri September 27, 2019

Michael Wang, MD, professor in the Department of Lymphoma and Myeloma at The University of Texas MD Anderson Cancer Center, discusses the potential role for the next-generation Bruton's tyrosine kinase (BTK) inhibitor zanubrutinib (BGB-3111) compared with first- and second-generation BTK inhibitors for the treatment of patients with mantle cell lymphoma (MCL).

Zanubrutinib is the newest BTK inhibitor to appear in the treatment landscape for patients with MCL, but it does not have significant follow-up time yet, Wang says. There are many interesting points for the role of zanubrutinib in MCL, and it is an active agent, according to Wang. This agent received priority review from the FDA in August 2019 for the treatment of patients with MCL who have received at least 1 prior treatment.

Zanubrutinib is a very positive drug, according to Wang. First- and second-generation BTK inhibitors do not differ significantly in terms of efficacy, but they differ in their toxicity profiles. For example, first-generation BTK inhibitor ibrutinib (Imbruvica) can lead to atrial fibrillation, infection, muscle spasms, and rash in patients with MCL, while acalabrutinib (Calquence), a second-generation drug, has a different toxicity profile. The most common adverse event with acalabrutinib in MCL is headache, Wang notes, which is expected to differ with zanubrutinib.
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