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Leo I. Gordon, MD, FACP


Does BTK Inhibitor Therapy Increase the Risk of HBV Reactivation in Those With Advanced DLBCL?

By: Vanessa A. Carter, BS
Posted: Wednesday, November 16, 2022

Ping Li, PhD, of Tongji Hospital, Tongji University School of Medicine, Shanghai, and colleagues explored the risk of hepatitis B virus (HBV) reactivation in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) treated with Bruton’s tyrosine kinase (BTK) inhibitors. Published in Frontiers in Immunology, the results of this study concluded that HBV infection does not, in fact, affect BTK inhibitor efficacy, although patients with a resolved infection do have a moderate risk of developing an infection.

“This is the first and largest research to evaluate the HBV reactivation incidence induced by BTK inhibitors and the efficacy of BTK inhibitors in HBV-associated relapsed or refractory DLBCL patients,” concluded the investigators. “Our research could help physicians to better select [patients] suitable for such a targeted treatment and provide the deeper and comprehensive understanding that BTK inhibitors could induce HBV reactivation in different types of B-cell [lymphoma].

The study authors focused on 55 patients with relapsed or refractory DLBCL undergoing BTK inhibitor therapy. Participant data such as clinical characteristics, HBV reactivation status, and treatment outcomes were retrospectively reviewed.

A total of 38 and 17 patients were treated with ibrutinib and zanubrutinib, respectively. Of the total population, 26 individuals had a resolved HBV infection (HBsAg-negative and HBcAb-positive), 25 did not have a record of HBV infection (HBsAg-negative and HBcAb-negative), and 4 experienced chronic HBV infection (HbsAg-positive). Of note, two participants with a resolved HBV infection developed HBV reactivation after treatment with zanubrutinib and ibrutinib, respectively, a frequency of 7.7%.

The overall response rate was 70.9%, and the 1-year overall survival rate was 80.0%. Additionally, the median progression-free survival was 4 months. In addition, HBV infection did not appear to correlate with response rates or survival among patients with relapsed or refractory DLBCL after treatment with BTK inhibitors.

Disclosure: The study authors reported no conflicts of interest.

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