Posted: Friday, July 29, 2022
For patients with mantle cell lymphoma previously treated with Bruton’s tyrosine kinase (BTK) inhibitors, the use of the noncovalent BTK inhibitor pirtobrutinib may be an efficacious therapeutic option, according to a poster presentation given at the 2022 Pan Pacific Lymphoma Conference. Pirtobrutinib has a favorable safety profile and is well tolerated by patients, according to Katharine Lewis, MD, of the Linear Clinical Research and Sir Charles Gairdner Hospital, Perth, Australia, and colleagues.
A total of 134 patients with classic (n = 108) or pleomorphic/blastoid (n = 26) mantle cell lymphoma were recruited for the study. Of the 111 patients who made up the efficacy population (those who had at least one post-baseline response assessment or had discontinued treatment prior to that first post-baseline response assessment), 100 had received previous treatment with BTK inhibitors, whereas 11 were treatment-naive. The study was divided into two phases of treatment. During phase I, patients began with 25 mg of pirtobrutinib and were gradually increased to a maximum dose of 300 mg. During phase II, patients were given 200 mg of pirtobrutinib.
The study findings revealed a 51% and 82% overall response rate for patients who received treatment with BTK inhibitors versus patients who did not, respectively. Additionally, activity was also seen in patients who had previous chimeric antigen receptor T-cell therapy (overall response rate [ORR] = 50%) and stem cell transplantation (ORR = 64%).
Furthermore, treatment-related adverse effects included fatigue (23%), bruising (22%), diarrhea (19%), neutropenia (18%), contusion (17%), rash (11%), arthralgia (11%), hemorrhage (8%), hypertension (7%), and atrial fibrillation or atrial flutter (2%). Moreover, 1% of patients discontinued treatment because of the severity of treatment-related adverse effects.
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