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BTK Inhibitors for Mantle Cell Lymphoma

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Published on July 30, 2020

BTK Inhibitors for Mantle Cell Lymphoma Treatment Are Showing Promising Results

Lymphoma expert Dr. Peter Martin explains why BTK Inhibitors may be used as frontline therapy. "Not everybody with mantle cell lymphoma needs or benefits from chemotherapy." 
"BTK Inhibitors have revolutionized the way we care with patients with mantle cell lymphoma," explains Dr. Peter Martin, Assistant Professor of Medicine in the Division of Hematology/Oncology at Weill Cornell Medical College and a member of the Center for Lymphoma and Myeloma. Dr. Martin and Patient Power co-founder Andrew Schorr discuss how BTK Inhibitors are currently being used as a mantle cell lymphoma treatment and the studies that are exploring how BTK Inhibitors work in combination with other drug therapies.


Transcript | BTK Inhibitors for Mantle Cell Lymphoma

Andrew Schorr:

We're visiting with Dr. Peter Martin head of the lymphoma service at Weill Cornell in New York. Dr. Martin, in mantle cell, there's really been a great addition of BTK inhibitors. So I think you have three now. You have acalabrutinib (Calquence), ibrutinib (Imbruvica), even zanubrutinib (Brukinsa) and maybe others coming, where do they fit in? And also, these are new agents. Do we know how long they'll work?

Dr. Martin:

The BTK inhibitors really have revolutionized the way we care for people with multiple different kinds of lymphoma, especially in mantle cell lymphoma. And I remember participating in some of the early clinical trials starting back 10 years ago and really being quite amazed by the activity at that time and continue to be a big supporter of them today. Early clinical trials really used the BTK inhibitors in people who had had multiple lines of prior therapy and did not necessarily have many treatment options remaining. More and more, we're seeing data emerging from people who have had less and less prior therapy, including a lot of people who have had only one line of prior therapy. And it really does appear that in that setting, in most people with mantle cell lymphoma, that BTK inhibitors can work for several months or years. I have some people who have been on them for several years now and so that's encouraging.

Clearly, there is room for improvement. I believe that, investigators from around the world believe that. And so what we see are a number of clinical trials partnering BTK inhibitors with other drugs for example, venetoclax (Venclexta) BCL-2 inhibitor, multiple PI3-kinase inhibitors, palbociclib (Ibrance) which is a CDK4 inhibitor that we have at Cornell and at other centers around the country. I think that we will see that certain combinations do have the potential to improve outcomes even further. And I do think that BTK inhibitors probably are most appropriately used currently in the second line setting in mantle cell lymphoma. I think we're also seeing them potentially moving into the first line setting. There are a number of clinical trials that have completed enrollment already. Others are ongoing combining chemotherapy with BTK inhibitors and even combining BTK inhibitors with other non-chemotherapy drugs sometimes the same ones that I mentioned. For example at Cornell. Dr. Jia Ruan is leading a clinical trial with acalabrutinib plus lenalidomide (Revlimid) plus rituximab (Rituxan).

And so it would be interesting to see. I think that again, the emerging data that we're seeing from some of these early trials suggests that not everybody with mantle cell lymphoma necessarily needs or benefits from chemotherapy. And it may be that the future for many people with mantle cell lymphoma doesn't include chemotherapy and really starts with novel agents.

Andrew Schorr:

Wow. That's exciting and I think a tremendous changing landscape in mantle cell that gives people a lot of hope for leading a longer life and fewer side effects, right?

Dr. Martin:

Yeah, it really does. I agree. I'm a big proponent of trying to move science forward as quickly as possible.

Andrew Schorr:

Okay. Dr. Peter Martin from Weill Cornell. Thank you for being with us.

Dr. Martin:

Thank you.

Andrew Schorr:

I'm Andrew Schorr. Remember, knowledge can be the best medicine of all.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.


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