The Use of Bruton Tyrosine Kinase Inhibitors in Waldenstrom's Macroglobulinemia

Waldenstrom's macroglobulinemia (WM) remains an incurable malignancy. However, a number of treatment options exist for patients with WM, including alkylating agents, anti-CD20 monoclonal antibodies, and small molecule inhibitors such as proteasome inhibitors and Bruton tyrosine kinase inhibitors (BTKi). The focus of this review is to highlight the role of BTKi in the management of WM. The first BTKi to receive US Food and Drug Administration approval for WM was ibrutinib. Ibrutinib has been extensively studied in both treatment-naive WM patients and in those with relapsed/refractory disease. The next BTKi approved for use was zanubrutinib, and prospective data for acalabrutinib and tirabrutinib have also recently been published. Efficacy data for BTKi will be discussed, as well as the differences in their adverse event profiles.

Automated summary

WM is an incurable malignancy, but treatment options like BTKi can help patients manage the disease. Ibrutinib was the first approved BTKi for WM by the FDA, with other BTKi such as zanubrutinib, acalabrutinib, and tirabrutinib also approved for use.