Author(s)

Yixin Guang, Yiqi Sheng, Haoyu Zheng

Corresponding Author

Haoyu Zheng

ABSTRACT

Bruton's tyrosine kinase (BTK) inhibitor is a new drug with the potential to be highly effective in B-cell malignancies. A 68 percent response rate was observed in 111 individuals with relapsed or refractory mantle-cell lymphoma in a phase 1 study of ibrutinib. However, atrial fibrillation, bleeding, hypertension, and diarrhea are found the ASPEN Phase III clinical study of Ibrutinib so that many patients discontinue treatment. Zanubritinib and acalabrutinib which are the 2nd generation BTK inhibitors shows higher safety and fewer off-target effects. Nowadays, while BTK inhibition is highly effective as a single agent therapy, side effects may occur, spurring the development of combination medicines that increase clinical outcomes. In this review, different therapies including mono-therapy and combination therapies will be analyzed. Mono-therapy comparison of first-generation BTK inhibitor ibrutinib and second-generation Zanubritinib in Waldenstroms macroglobulinemia (WM), Chronic lymphocytic leukemia (CLL) and Mantle Cell Lymphoma (MCL) should be analyzed. Some examples would be administered in conjunction with ibrutinib, acalabrutinib, and abietinic combination therapy in CLL and MCL.

KEYWORDS

Bruton's tyrosine kinase (BTK), Ibrutinib, Acalabrutinib, Zanubrutinib, B cell malignancies