Managing Ibrutinib-Intolerant Patients With B-Cell Malignancies.
Javier MuñozShayna SarosiekJorge J CastilloPublished in: The oncologist (2023)
Ibrutinib is a first-generation inhibitor of Bruton tyrosine kinase (BTK) that is currently approved to treat patients with B-cell malignancies, including Waldenström macroglobulinemia (WM), relapsed/refractory (R/R) mantle cell lymphoma (MCL), R/R marginal zone lymphoma (MZL), and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). Off-target adverse effects, such as atrial fibrillation, hypertension, and bleeding, have been observed and may limit a patient's tolerance for treatment. Currently, there is no well-established treatment regimen for patients who cannot tolerate ibrutinib. Approaches to address such patients include managing ibrutinib side effects with supportive care or dose reductions, switching to an alternative covalent BTK inhibitor, or abandoning covalent BTK inhibitors for alternative forms of treatment. Here we review the literature and provide guidance on treating ibrutinib-intolerant patients with B-cell malignancies.
Keyphrases
- chronic lymphocytic leukemia
- tyrosine kinase
- atrial fibrillation
- healthcare
- epidermal growth factor receptor
- diffuse large b cell lymphoma
- systematic review
- end stage renal disease
- acute lymphoblastic leukemia
- palliative care
- chronic kidney disease
- acute coronary syndrome
- quality improvement
- pain management
- multiple myeloma
- percutaneous coronary intervention
- venous thromboembolism
- combination therapy
- chronic pain
- catheter ablation
- health insurance
- smoking cessation
- affordable care act