Ian Flinn, MD, PhD: Bruton's Tyrosine Kinase Therapy Offers Fewer Adverse Events for CLL, SLL

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Dr. Ian Flinn says many patients opt for treatment with Bruton's tyrosine kinase (BTK) over combination therapy.

In an interview with HCPLive, Ian W. Flinn, MD, PhD, Director, Lymphoma Research, Sarah Cannon Research Institute at Tennessee Oncology, spoke on the US Food and Drug Administration's (FDA) approval of zanubrutinib (Brukinsa) and its importance for patients and providers dealing with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL), rare forms of cancer.

Supporting data from the SEQUOIA and ALPINE trials assessed the efficacy of zanubrutinib in these populations.

The phase 3 SEQUOIA study evaluated treatment-naïve patients with CLL/SLL in randomized and non-randomized cohorts. In the randomized cohort, 479 patients, including patients without 17p deletion, underwent treatment of zanubrutinib until disease progression, or 6 cycles of bendamustine alongside rituximab. Progression-free survival was the main efficacy outcome.

In ALPINE, the second clinical trial, a total of 652 patients with relapsed or refractory CLL/SLL received either zanubrutinib or ibrutinib following randomization. The median amount of prior lines of therapy was 1, and ranged from 1-8. The overall response rate, and duration of response, were measures for the main efficacy outcome.

As a Bruton's tyrosine kinase (BTK) therapy, zanubrutinib provides an alternative treatment option to traditional therapies.

"Patients get that therapy for about a year, and then they can come off. They only have to stay on it for about a year because they get very deep remissions. Many patients have undetectable, minimal residual disease," he said. "It's a little bit of pain to give that therapy because it's it's very intensive."

Because the therapy involves 5 weeks of dose escalation, which means patients are visiting their treatment center multiple times per week to avoid tumor lysis syndrome (TLS), the approval of zanubrutinib as an option was significant. Flinn shared that many patients opt for Bruton's tyrosine kinase (BTK) over this combination therapy.