Toby Eyre, MCBhB, MRCP, consultant hematologist at Oxford University Hospitals NHS Trust, discusses resistance to BTK inhibition in mantle cell lymphoma (MCL).

In a study presented at the 2018 European Hematology Association Congress, venetoclax (Venclexta) monotherapy induced an overall response rate (ORR) of 60% in patients with poor-risk relapsed/refractory MCL previously treated with a BTK inhibitor. Patients who develop resistance to BTK inhibitors are a big unmet need in MCL, explains Eyre, accounting for approximately 30% of the overall population.

In a phase II study with ibrutinib (Imbruvica) monotherapy (NCT01236391), the ORR in relapsed/refractory patients was 68%, with a complete response of 21%, which left approximately 30% of patients with no suitable treatment alternatives. Additionally, the progression-free survival was just over 1 year, suggesting that many of the patients who do respond to the inhibitor will experience relapse. Within 1 or 2 years of BTK inhibitor therapy, the majority of patients will require another line of therapy, explains Eyre.

Toby Eyre, MCBhB, MRCP

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Dr. Eyre on Resistance to BTK Inhibition in MCL