Comparative Efficacy of BTK Inhibitors in Treatment-Naïve and Relapsed/Refractory Mantle Cell Lymphoma: A Systematic Review and Meta-Analysis.

What was studied

This review compared BTK inhibitors in mantle cell lymphoma. The drugs were ibrutinib, zanubrutinib and acalabrutinib. It looked at people with untreated disease. It also looked at people with relapsed or refractory disease. The search ran up to January 2025. It covered 70 studies.

What they found

Complete response was more common in untreated people than in relapsed people. In untreated people, zanubrutinib regimens had a higher rate. The gap versus acalabrutinib or ibrutinib regimens was significant. In relapsed disease, combined plans with an anti-CD20 antibody had a higher rate. On its own, acalabrutinib had a higher rate than the others. Zanubrutinib had fewer blood toxicities.

What it means for patients

The authors say acalabrutinib and zanubrutinib show first-line potential. They say chemotherapy-free plans may partly overcome the poor outlook in relapsed disease. They say the findings may support updated guidelines.

Why it is not certain yet

The studies were randomized and single-arm trials. The authors say chemotherapy-free plans need more checks in randomized trials. The abstract gives no head-to-head trial results. Links across trials are not proof of cause. The data come from other studies. New data may change the picture. It is a pooled review of other work.

Source

Comparative Efficacy of BTK Inhibitors in Treatment-Naïve and Relapsed/Refractory Mantle Cell Lymphoma: A Systematic Review and Meta-Analysis.

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