Spotlight on Ibrutinib in PCNSL: Adding Another Feather to Its Cap

Lakshmanan, Aparna; Byrd, John C.

doi:10.1158/2159-8290.cd-17-0714

Cited by 8 publications
(3 citation statements)

References 14 publications

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“…Our findings showed that regardless of whether there was a MYD88 or CD79B mutation, ibrutinib achieved considerable curative effect. We suspect that the possible reason is that ibrutinib is not only an irreversible BTK inhibitor, as increasing evidence in vivo and in vitro indicate, it is also an inhibitor of IL2-inducible T cell kinase (ITK), which can provide a wider range of alternative therapeutic effects as an immunomodulator ( 5 ). Thus, ibrutinib can also influence other immune cells and kinases, induce CD4+ T cells to differentiate into helper T cells (Th1), and enhance tumor immune surveillance ( 34 ).…”

Section: Discussionmentioning
confidence: 99%

“…In recent years, studies on PCNSL have found that Bruton tyrosine kinase (BTK) plays an important role in regulating the oncogenic signal transduction downstream of B-cell antigen receptor (BCR) and Toll-like receptor (TLR) ( 4 ). Ibrutinib, an oral irreversible inhibitor of BTK, is considered to be effective for the treatment of CNSL, especially r/r CNSL ( 5 ); however, the exact efficacy and safety of ibrutinib in the treatment of CNSL is still unclear. The purpose of this meta-analysis was to study the effectiveness and safety of ibrutinib-based treatment in CNSL patients.…”

Section: Introductionmentioning
confidence: 99%

See 1 more Smart Citation
Efficacy and Safety of Ibrutinib in Central Nervous System Lymphoma: A PRISMA-Compliant Single-Arm Meta-Analysis
Lv
¹
,
Sun
²
,
Wu
³

et al. 2021
Front. Oncol.
15
1
12
0
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BackgroundCentral nervous system lymphoma (CNSL) is an aggressive lymphoma. Studies investigating primary CNSL determined that the Bruton tyrosine kinase (BTK) played an important role in pathogenesis. Ibrutinib, an oral BTK inhibitor, is a new treatment strategy for CNSL. The purpose of this meta-analysis was to clarify the effectiveness and safety of ibrutinib in the treatment of CNSL.MethodsA systematic search of PubMed, Embase, Cochrane library, Wanfang Data Knowledge Service Platform, and China National Knowledge Infrastructure databases was conducted through to 31 October 2019. Studies involving patients with CNSL who received ibrutinib that reported the overall response (OR), complete remission (CR), and partial response (PR) were included. The random-effects or fixed-effects model with double arcsine transformation was used for the pooled rates and 95% confidence intervals (CI) were determined for all outcomes.ResultsEight studies including 162 patients were identified and included in the meta-analysis. The pooled OR rate after treatment with ibrutinib was 69% (95% CI, 61–79%, I2 = 47.57%, p = 0.06), while the pooled CR and PR was 52% (95% CI, 35–68%, I2 = 74.95%, p = 0.00) and 17% (95% CI, 7–30%, I2 = 67.85%, p = 0.00), respectively. Among PCNSL patients, including new diagnoses PCNSL and R/R PCNSL, the pooled OR rate was 72% (95% CI, 63–80%, I2 = 49.20%, p = 0.06) while the pooled CR and PR rates were 53% (95% CI, 33–73%, I2 = 75.04%, p = 0.00) and 22% (95% CI, 14–30%, I2 = 46.30%, p = 0.07), respectively. Common adverse events above grade 3 included cytopenia and infections.ConclusionsThe ibrutinib-containing therapy was well tolerated and offered incremental benefit to patients with CNSL. However, randomized-controlled studies that directly compare efficacy and adverse events of ibrutinib are still needed.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42020218974.
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Section: Discussionmentioning
confidence: 99%

Section: Introductionmentioning
confidence: 99%

Efficacy and Safety of Ibrutinib in Central Nervous System Lymphoma: A PRISMA-Compliant Single-Arm Meta-Analysis
Lv
¹
,
Sun
²
,
Wu
³

et al. 2021
Front. Oncol.
15
1
12
0
View full text Add to dashboard Cite

BackgroundCentral nervous system lymphoma (CNSL) is an aggressive lymphoma. Studies investigating primary CNSL determined that the Bruton tyrosine kinase (BTK) played an important role in pathogenesis. Ibrutinib, an oral BTK inhibitor, is a new treatment strategy for CNSL. The purpose of this meta-analysis was to clarify the effectiveness and safety of ibrutinib in the treatment of CNSL.MethodsA systematic search of PubMed, Embase, Cochrane library, Wanfang Data Knowledge Service Platform, and China National Knowledge Infrastructure databases was conducted through to 31 October 2019. Studies involving patients with CNSL who received ibrutinib that reported the overall response (OR), complete remission (CR), and partial response (PR) were included. The random-effects or fixed-effects model with double arcsine transformation was used for the pooled rates and 95% confidence intervals (CI) were determined for all outcomes.ResultsEight studies including 162 patients were identified and included in the meta-analysis. The pooled OR rate after treatment with ibrutinib was 69% (95% CI, 61–79%, I2 = 47.57%, p = 0.06), while the pooled CR and PR was 52% (95% CI, 35–68%, I2 = 74.95%, p = 0.00) and 17% (95% CI, 7–30%, I2 = 67.85%, p = 0.00), respectively. Among PCNSL patients, including new diagnoses PCNSL and R/R PCNSL, the pooled OR rate was 72% (95% CI, 63–80%, I2 = 49.20%, p = 0.06) while the pooled CR and PR rates were 53% (95% CI, 33–73%, I2 = 75.04%, p = 0.00) and 22% (95% CI, 14–30%, I2 = 46.30%, p = 0.07), respectively. Common adverse events above grade 3 included cytopenia and infections.ConclusionsThe ibrutinib-containing therapy was well tolerated and offered incremental benefit to patients with CNSL. However, randomized-controlled studies that directly compare efficacy and adverse events of ibrutinib are still needed.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42020218974.

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“…[1] Ibrutinib is reported effective in the treatment of primary central nervous system lymphoma, especially refractory and relapsed. [10] However, the exact efficacy of ibrutinib in the treatment of primary central nervous system lymphoma is unclear. [1] Also, ibrutinib treatment has fungal infections and atrial fibrillation as adverse effects.…”

Section: Introductionmentioning
confidence: 99%

Orelabrutinib versus ibrutinib for patients with refractory/relapsed primary central nervous system lymphoma: An efficacy and safety analysis
Qiao
¹
,
Liu
²
,
Huang
³

2023
Medicine
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0
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Ibrutinib is reported effective in the management of refractory/relapsed primary central nervous system lymphoma but it has adverse effects. Orelabrutinib has received its first approval for the treatment of refractory/relapsed lymphoma either alone or with chemotherapy in China. The objectives of the retrospective study were to evaluate the efficacy and safety of treatment a combination of orelabrutinib (150 mg/day) and rituximab (250 mg/m2 per week), versus orelabrutinib alone (100 mg twice a day) and ibrutinib alone (560 mg/day) among patients with refractory/relapsed primary central nervous system lymphoma. Patients received 150 mg/day orelabrutinib with 250 mg/m2 rituximab/week (RO cohort, n = 105) or 100 mg twice in a day orelabrutinib (OB cohort, n = 107) or 560 mg/day ibrutinib (IB cohort, n = 117) until intolerable toxicity. Patients of the OB cohort continue treatment(s) for longer time than those patients of the RO and the IB cohorts (P < .05 for both). Overall response rate (complete response + partial response) and disease control rates (complete response + partial response + no signs of progressive response) were higher for patients of the RO cohort than those of the IB cohort (P < .0001 for both). The disease control rate was higher for patients of the OB cohort than those of the IB cohort (P = .0062). The overall response rate was higher for patients of the RO cohort than those of the OB cohort (P = .0188). Progression-free survival (from the initiation of disease treatment(s) to disease progression) of patients of the RO and OB cohorts were higher than those of the IB cohort (P < .0001 for both). Overall survival (from the initiation of disease treatment(s) to death) of the patients of the IB cohort was fewer than those of the RO (P = .0444) and the OB (P = .0163) cohorts. Ibrutinib cause bleeding events, and orelabrutinib caused leukopenia, purpura diarrhea, fatigue, and drowsiness. Rituximab and ibrutinib cause fungal infections, atrial fibrillation, bacterial and viral infection(s), hypertension, and tumor lysis syndrome. A total of 150 mg/day oral orelabrutinib plus 250 mg/m2 intravenous rituximab/week is efficacious and safe for patients with refractory/relapsed primary central nervous system lymphoma (Level of Evidence: IV; Technical Efficacy Stage: 5).

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Fungal Infections in the Setting of Biological Therapies (in the Non-Transplant Host)
Lionakis
¹

2021
Encyclopedia of Mycology
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0
0
0
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Spotlight on Ibrutinib in PCNSL: Adding Another Feather to Its Cap

Cited by 8 publications

References 14 publications

Efficacy and Safety of Ibrutinib in Central Nervous System Lymphoma: A PRISMA-Compliant Single-Arm Meta-Analysis

Efficacy and Safety of Ibrutinib in Central Nervous System Lymphoma: A PRISMA-Compliant Single-Arm Meta-Analysis

Orelabrutinib versus ibrutinib for patients with refractory/relapsed primary central nervous system lymphoma: An efficacy and safety analysis

Fungal Infections in the Setting of Biological Therapies (in the Non-Transplant Host)

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