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Evaluation of orelabrutinib monotherapy in patients with relapsed or refractory Waldenstrom's macroglobulinemia in a single-arm, multicenter, open-label, phase 2 study.


ABSTRACT:

Background

Orelabrutinib is a novel, small molecule, selective irreversible Bruton tyrosine kinase inhibitor. The purpose of this study was to evaluate the efficacy and safety of orelabrutinib in patients with relapsed or refractory Waldenström's macroglobulinemia (R/R WM).

Methods

This is a prospective, multicenter study of orelabrutinib in patients with WM who had at least one prior line of treatment. Orelabrutinib was administered orally at a daily dose of 150 mg until disease progression or unacceptable toxicity. The primary endpoint was major response rate (MRR) assessed by the Independent Review Committee (IRC) according to IWWM-6. This study is registered with ClinicalTrials.gov, NCT04440059. This trial was also registered on Center for Drug Evaluation (www.chinadrugtrials.org.cn) in March 2019, with a number of CTR2019036.

Findings

Between August 2019 and December 2020, 66 R/R WM patients were assessed for eligibility. Forty-seven eligible patients were evaluated for efficacy at a median follow-up of 16.4 months (interquartile range: 12.5, 19.5). As assessed by IRC, the MRR was 80.9%, and the overall response rate was 89.4%. The median time to at least a minor response was 1.9 months. The PFS rates was 89.4% at 12 months. For patients with MYD88L265P /CXCR4NEG, MYD88L265P /CXCR4 S338X, and MYD88NEG /CXCR4NEG mutations, the MRRs were 84.6%, 100%, and 25.0%. Most adverse events were Grades 1 or 2 (91.0%). The common grade 3 or higher adverse events occurring were neutropenia (10.6%), thrombocytopenia (6.4%), and pneumonia (4.3%). Serious adverse events (SAE) occurred in 10 patients (21.3%). One treatment-related death was reported (hepatitis B reactivation).

Interpretation

Orelabrutinib has shown good efficacy and manageable safety profiles in patients with R/R WM.

Funding

InnoCare Pharma.

SUBMITTER: Cao XX 

PROVIDER: S-EPMC9596308 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Publications

Evaluation of orelabrutinib monotherapy in patients with relapsed or refractory Waldenström's macroglobulinemia in a single-arm, multicenter, open-label, phase 2 study.

Cao Xin-Xin XX   Jin Jie J   Fu Cheng-Cheng CC   Yi Shu-Hua SH   Zhao Wei-Li WL   Sun Zi-Min ZM   Yang Wei W   Li Deng-Ju DJ   Cui Guo-Hui GH   Hu Jian-da JD   Liu Ting T   Song Yong-Ping YP   Xu Bing B   Zhu Zun-Min ZM   Xu Wei W   Zhang Ming-Zhi MZ   Tian Ya-Min YM   Zhang Bin B   Zhao Ren-Bin RB   Zhou Dao-Bin DB  

EClinicalMedicine 20221004


<h4>Background</h4>Orelabrutinib is a novel, small molecule, selective irreversible Bruton tyrosine kinase inhibitor. The purpose of this study was to evaluate the efficacy and safety of orelabrutinib in patients with relapsed or refractory Waldenström's macroglobulinemia (R/R WM).<h4>Methods</h4>This is a prospective, multicenter study of orelabrutinib in patients with WM who had at least one prior line of treatment. Orelabrutinib was administered orally at a daily dose of 150 mg until disease  ...[more]

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