Evaluating ibrutinib for the treatment of relapsed/refractory marginal zone lymphoma

ABSTRACT

Introduction: Marginal zone lymphoma (MZL) is a heterogeneous disease with a wide range of possible frontline therapies depending on the subtype; there are no shared guidelines for the treatment of relapsed/refractory MZLs. The growing evidence of the importance of the BCR pathway in the pathogenesis of B lymphoproliferative forms has led researchers to consider BTK as a potential therapeutic target in MZL.

Area covered: The authors provide the reader with an evaluation of ibrutinib as a treatment option for refractory marginal zone lymphoma. The review includes an overview of the drug’s pharmacokinetics and pharmacodynamics, efficacy, and safety. The authors also provide the reader with their expert perspectives on the drug and its place in the treatment of MZL.

Expert opinion: The availability of new non-chemotherapeutic agents represents an important opportunity to spare excessive exposure to cytotoxic compounds. Immunomodulators and targeted agents, alone or often in combination with immunotherapy, have been shown to be effective and safe therapies in patients with relapsed/refractory (R/R) MZL. In addition, numerous studies involving new generation targeted agents, alone or in combination, are currently active in both R/R and untreated patient populations, some with encouraging preliminary results.

KEYWORDS:

• Marginal zone lymphoma
• bruton tyrosine kinase
• indolent non hodgkin lymphoma
• targeted therapy

Declaration of interest

C Cavalloni has received honoraria for serving in an advisory capacity for Novartis. M Varettoni received honoraria for serving in an advisory capacity for Janssen Pharmaceuticals, Roche, AstraZeneca and for travel expenses from AbbVie and Janssen Pharmaceuticals. L Arcaini meanwhile received honoraria for serving in an advisory capacity from Roche, Celgene, Janssen-Cilag, VeraStem, Eusa Pharma, and Incyte, as well as research support from Gilead Sciences, and travel expenses from Roche, Celgene, Janssen-Cilag, and Eusa Pharma. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer Disclosures

One reviewer declared that they have received research support from AstraZeneca-Acerta for the study of acalabrutinib in follicular lymphoma. Peer reviewers in this manuscript have no other relevant financial relationships or otherwise to disclose.

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