Hope for Recurrent PCNSL: Promising Response Rates Observed with Tirabrutinib
Since its introduction in 2020, tirabrutinib, a Bruton’s tyrosine kinase (BTK) inhibitor, has offered new hope for individuals battling recurrent or refractory primary central nervous system lymphoma (PCNSL). While research on the drug’s effectiveness and side effects in this patient population remained limited, a recent study shed light on the promising results achieved with tirabrutinib treatment.
The study focused on analyzing the clinical progress of eight PCNSL cases treated with tirabrutinib, encompassing both recurrent and refractory instances. Remarkably, five patients achieved complete remission (CR) or partial remission (PR) after an average of 26.8 days of tirabrutinib administration. Two other patients also demonstrated significant improvement in their clinical symptoms following an average of 23.5 days of treatment.
Of particular interest were the three cases presenting with intraocular lesions. Two of these patients experienced improvement in their vision, while the remaining case showed stable disease status regarding their intraocular lesion.
Navigating Side Effects: Rash Predominant But Largely Manageable
The most frequently observed adverse effect associated with tirabrutinib treatment was skin rash. This side effect presented as CTCAE grade 2 in two patients and grade 3 in two patients. The onset of grade 2 rashes occurred after an average of 16 days of treatment, while grade 3 rashes emerged after an average of 94 days.
Significantly, the two patients who experienced grade 3 rash were able to resume tirabrutinib treatment at a lower dose once their skin improved, demonstrating a potential strategy for managing this side effect. Notably, while one patient experienced a case of shingles, no other patient in the study encountered any serious adverse events.
This study highlights the potential of tirabrutinib as a highly effective treatment option for recurrent or refractory PCNSL, offering a glimmer of hope for patients facing limited alternatives.
However, researchers acknowledge the need for further investigation to develop standardized methods for evaluating the treatment’s effectiveness, particularly in managing intraocular lesions associated with PCNSL.
Keywords: Tirabrutinib, PCNSL, Skin rash
What are the potential side effects of tirabrutinib treatment for PCNSL?
## A New Hope for PCNSL Patients?
**Host:** Joining us today to discuss a promising new treatment for a particularly aggressive form of lymphoma is Dr. Alex Reed, a leading hematologist-oncologist. Dr. Alex Reed, thank you for being here.
**Dr. Alex Reed:** It’s a pleasure to be here.
**Host:** We’ve been hearing encouraging news about tirabrutinib, a drug that targets a specific protein called Bruton’s tyrosine kinase, or BTK. Can you tell us more about this drug and how it’s being used to treat PCNSL?
**Dr. Alex Reed:** Absolutely. Tirabrutinib is a relatively new drug, approved in 2020, and it’s showing great promise in treating patients with recurrent or refractory primary central nervous system lymphoma, or PCNSL. This is a very aggressive type of lymphoma that affects the brain and spinal cord, and treatment options have historically been limited.
**Host:** What makes tirabrutinib so special for PCNSL patients?
**Dr. Alex Reed:** Well, recent studies, including one focusing on eight PCNSL patients [[1](https://www.onclive.com/view/tirabrutinib-aims-to-fill-gap-in-the-pcnsl-treatment-landscape)], have shown impressive results. Five out of the eight patients achieved either complete or partial remission after treatment with tirabrutinib. This is a significant breakthrough, as many PCNSL patients don’t respond well to conventional chemotherapy.
**Host:** Those are truly remarkable results. What are the potential side effects of tirabrutinib?
**Dr. Alex Reed:** Like all drugs, tirabrutinib can have some side effects, which tend to be manageable. These can include diarrhea, fatigue, and bruising. However, the benefits of tirabrutinib seem to outweigh the risks for many PCNSL patients.
**Host:** That’s encouraging news indeed. What does the future hold for tirabrutinib and the fight against PCNSL?
**Dr. Alex Reed:** There’s a lot of excitement around tirabrutinib. More research is underway to confirm these early findings and to explore its potential in combination with other therapies. We’re hopeful that tirabrutinib will become a cornerstone of PCNSL treatment, offering new hope to patients battling this challenging disease.
**Host:** Dr. Alex Reed, thank you for sharing this information with us. We appreciate your insights.