Dr. Hill Discusses BTK Inhibitors in Mantle Cell Lymphoma

Brian T. Hill, MD, PhD, assistant professor, Hematology and Oncology, Cleveland Clinic, discusses BTK inhibitors in mantle cell lymphoma (MCL).

Acalabrutinib (Calquence) joined ibrutinib (Imbruvica) in late 2017 as the second FDA-approved BTK inhibitor for the treatment of patients with MCL. The approval of acalabrutinib was based on findings from the phase II ACE-LY-004 trial, in which the investigator assessed an objective response rate of 81%.

Hill says that although there are no head-to-head data with acalabrutinib and ibrutinib in MCL, the response rates with acalabrutinib are on par with what are seen with ibrutinib, but the tolerability with acalabrutinib seems to be better.

Additional BTK inhibitors are in development, says Hill, many of which are covalent inhibitors that bind to the same residue as ibrutinib. Some of the non-covalent inhibitors in development may be able to overcome the point mutation in BTK that confers resistance to ibrutinib.