Review of Bruton Tyrosine Kinase Inhibitors for the Treatment of Relapsed or Refractory Mantle Cell Lymphoma

Curr Oncol. 2019 Apr;26(2):e233-e240. doi: 10.3747/co.26.4345. Epub 2019 Apr 1.


Mantle cell lymphoma (mcl) is a rare subtype of aggressive B-cell non-Hodgkin lymphoma that remains incurable with standard therapy. Patients typically require multiple lines of therapy, and those with relapsed or refractory (r/r) disease have a very poor prognosis. The Bruton tyrosine kinase (btk) inhibitor ibrutinib has proven to be an effective agent for patients with r/r mcl. Although usually well tolerated, ibrutinib can be associated with unique toxicities, requiring discontinuation in some patients. Effective and well-tolerated alternatives to ibrutinib for patients with r/r mcl are therefore needed. Novel btk inhibitors such as acalabrutinib, zanubrutinib, and tirabrutinib are designed to improve on the safety and efficacy of first-generation btk inhibitors such as ibrutinib. Data from single-arm clinical trials suggest that, compared with ibrutinib, second-generation btk inhibitors have comparable efficacy and might have a more favourable toxicity profile. Those newer btk inhibitors might therefore provide a viable treatment option for patients with r/r mcl.

Keywords: Bruton tyrosine kinase inhibitors; acalabrutinib; mantle cell lymphoma.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Agammaglobulinaemia Tyrosine Kinase / antagonists & inhibitors*
  • Antineoplastic Agents / therapeutic use*
  • Drug Resistance, Neoplasm
  • Humans
  • Lymphoma, Mantle-Cell / drug therapy*
  • Neoplasm Recurrence, Local / drug therapy
  • Protein Kinase Inhibitors / therapeutic use*
  • Recurrence


  • Antineoplastic Agents
  • Protein Kinase Inhibitors
  • Agammaglobulinaemia Tyrosine Kinase