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Zanubrutinib Versus Standard BTK Inhibitors in B-Cell Malignancy: Pooled Safety Analysis

By: Joshua D. Madera, MS
Posted: Tuesday, February 1, 2022

Use of the selective Bruton’s tyrosine kinase inhibitor (BTK) zanubrutinib for the treatment of B-cell malignancies was shown to be generally well tolerated, according to a pooled safety analysis published in Blood Advances. Zanubrutinib had a reported safety profile that aligns with known BTK inhibitor toxicities, all of which were mostly reversible and manageable, explained Constantine S. Tam, MD, of St. Vincent’s Hospital, Australia, and colleagues.

The authors focused on 779 patients with B-cell malignancies from 6 multicenter studies. B-cell malignancies included Waldenström’s macroglobulinemia (33%), chronic lymphocytic leukemia or small lymphocytic lymphoma (29%), and mantle cell lymphoma (19%). All patients received zanubrutinib therapy in doses ranging from 40 mg to 320 mg daily.

The median duration of treatment was 26 months, with 16% of patients having been treated for at least 3 years. Nonhematologic treatment-emergent adverse effects included upper respiratory tract infection (39%), rash (27%), bruising (25%), musculoskeletal pain (24%), diarrhea (23%), cough (21%), pneumonia (21%), urinary tract infection (15%), and fatigue (15%). Furthermore, as compared with ibrutinib, zanubrutinib therapy resulted in a decreased incidence of hypertension, diarrhea, and atrial fibrillation. In addition, neutropenia (23%), thrombocytopenia (8%), and anemia (8%) were common adverse events of grade 3 or higher. A total of 4% of patients experienced fatal adverse effects, such as pneumonia, multiple organ dysfunction syndrome, and sepsis.

Disclosure: For full disclosures of the study authors, visit

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