Medically reviewed by Dr. Brian Koffman
The Bottom Line:
Zanubrutinib is an excellent option for patients with CLL / SLL who are unable to tolerate acalabrutinib due to side effects. Zanubrutinib was well-tolerated and provided disease control in patients with B-cell cancers who had previously stopped acalabrutinib due to intolerance.
Who Performed the Research and Where Was it Presented:
Dr. Mazyar Shadman from Fred Hutchinson Cancer Center and colleagues presented the results at the American Society for Hematology (ASH) Annual Meeting in 2023.
Background:
Bruton tyrosine kinase (BTK) inhibitors are very effective for treating chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL), but they must be taken continuously, which can be very difficult for patients who experience side effects. Fortunately, we now have multiple options available as second-generation BTK inhibitors such as acalabrutinib and zanubrutinib have been approved. These newer BTK inhibitors have fewer side effects, but they are not perfect for everyone. Researchers wanted to know more about whether switching between different covalent BTK inhibitors could help patients with intolerance due to side effects.
Methods and Participants:
This study is an update from an ongoing phase 2 clinical trial that is evaluating the safety and efficacy of zanubrutinib in patients with B-cell cancers who had become intolerant to prior BTKi therapy (ibrutinib or acalabrutinib). Investigators evaluated the recurrence and change in severity of ibrutinib or acalabrutinib intolerance events (side effects which caused patients to discontinue ibrutinib or acalabrutinib).
Results:
- The results presented here are specifically for the cohort of patients who were intolerant of acalabrutinib.
- Thus far, 27 patients with acalabrutinib intolerance have been enrolled and received zanubrutinib for a median treatment duration of 11 months. Of these patients, 19 had CLL / SLL.
- The most common acalabrutinib intolerance events were joint pain, headache, muscle pain, diarrhea, and rash.
- In total, 70% of acalabrutinib intolerance events did not recur with zanubrutinib, which corresponds to 63% of patients not experiencing recurrence of an acalabrutinib intolerance event.
- Almost all patients (96%) maintained or improved their response to treatment, meaning they had at least stable disease.
Conclusions:
Zanubrutinib is an excellent option for patients who are unable to tolerate acalabrutinib due to side effects. Zanubrutinib was well-tolerated and provided disease control in patients with B-cell cancers who had previously stopped acalabrutinib due to intolerance. Switching between different covalent BTK inhibitors can allow patients to continue getting the benefits of a BTK inhibitor with fewer side effects.
Links and Resources:
Watch the interview on the abstract here:
You can read the actual ASH abstract here: Zanubrutinib in Acalabrutinib-Intolerant Patients (Pts) with B-Cell Malignancies
Take care of yourself first.
Ann Liu, PhD
