A Targeted Lymphoma Drug
- Ibrutinib (Imbruvica) blocks the signals that help lymphoma cells grow
- It’s often given when the cancer comes back after the first treatment
- Researchers are studying new combinations of this drug with chemotherapy as a first treatment for lymphoma
In the past, chemotherapy was one of the only options for treating people with non-Hodgkin lymphoma. Chemo goes after rapidly dividing cells, but it can destroy healthy cells in the process, which can lead to side effects like hair loss and nausea. Today, there are drugs like ibrutinib (Imbruvica), which target cancer cells more precisely. These drugs are proving very effective against several different types of lymphoma.
“Ibrutinib is a BTK inhibitor. That’s a Bruton’s tyrosine kinase inhibitor,” Dr. Sairah Ahmed, associate professor in the Department of Lymphoma/Myeloma, Division of Cancer Medicine, at MD Anderson Cancer Center tells SurvivorNet.
BTK inhibitors are a type of drug known as cell signal inhibitors. All cells, including cancer cells, receive signals that help them divide and grow. Imbruvica targets a protein called BTK, which is part of a pathway that helps cancer cells multiply and spread. By blocking BTK, this drug prevents cancer cells from growing.
Imbruvica comes as a pill that you take once a day. The dosage your doctor prescribes is based on the type of lymphoma you have.
Who Can Take Imbruvica?
This drug may be an option for you if you have one of these types of lymphoma:
- Mantle cell lymphoma (MCL)
- Chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL)
- Marginal zone lymphoma (MZL)
- Lymphoplasmacytic lymphoma (LPL)
It’s also being used experimentally in some people with diffuse large B-cell lymphoma. Typically, you’ll only get this drug after you’ve already tried another treatment and your cancer has come back, or relapsed. “Most often if you’re going to receive ibrutinib, it’s going to be when lymphoma has returned when you’re talking about diffuse large B-cell lymphoma,” Dr. Ahmed says.
A couple of the doctors she works with at MD Anderson are studying Imbruvica combined with chemotherapy and other medicines as the first treatment for lymphoma. One of these trials is combining Imbruvica with chemotherapy and the immunotherapy drug, rituximab (Rituxan), a combination that doctors call “chemoimmunotherapy.” Dr. Ahmed tells SurvivorNet the researchers have had “excellent results” so far when using this combination on diffuse large B-cell lymphoma.
Other clinical trials are investigating Imbruvica in combination with chemotherapy as a first treatment for a type of diffuse large B-cell lymphoma called non-germinal, or non-GCB cancer. Those studies haven’t shown enough improvement for the FDA to approve Imbruvica as an initial treatment for this cancer type.
Dr. Ahmed believes that the combination of immunotherapy, other new treatments, and conventional chemotherapy “is what we’re going to see in the future.” Doctors will continue to fine-tune the doses and monitor for side effects as they look for the most effective ways to combine these cancer drugs.
What Are the Side Effects?
Overall, Imbruvica is very well tolerated, Dr. Ahmed says. Just like any other cancer drug, it can cause side effects, though. The most common ones are:
- Diarrhea
- Fatigue
- Bruising and bleeding
- Low blood cell counts
- Joint and muscle pain
- Increased risk for infections
It can also cause irregular heart rhythms (arrhythmias). Often, that’s more of a problem for people who started out with heart problems, but even those who haven’t had a heart issue in the past can develop an arrhythmia for the first time while taking Imbruvica.
“That’s why, when it’s given, even though it’s an oral chemotherapy, it needs to be monitored closely,” Dr. Ahmed says. “Patients still need to have bloodwork and see their oncologist once a month as they get that drug.”
If you notice any side effects while on cancer treatment, it’s important to mention them to your doctor. You might need an adjustment in dose, or, if the side effect is serious enough, to go off the drug entirely. We now have other drugs in the same class as Imbruvica — BTK inhibitors — but with different side effect profiles that may be options if you have intolerable side effects from Imbruvica.
Learn more about SurvivorNet's rigorous medical review process.
Dr. Sairah Ahmed is associate professor in the Department of Lymphoma/Myeloma, Division of Cancer Medicine, at MD Anderson Cancer Center in Houston, Texas. She is board-certified in internal medicine, hematology, and medical oncology. Read More
A Targeted Lymphoma Drug
- Ibrutinib (Imbruvica) blocks the signals that help lymphoma cells grow
- It’s often given when the cancer comes back after the first treatment
- Researchers are studying new combinations of this drug with chemotherapy as a first treatment for lymphoma
In the past, chemotherapy was one of the only options for treating people with non-Hodgkin lymphoma. Chemo goes after rapidly dividing cells, but it can destroy healthy cells in the process, which can lead to side effects like
hair loss and
nausea. Today, there are drugs like
ibrutinib (Imbruvica), which target cancer cells more precisely. These drugs are proving very effective against several different types of lymphoma.
“Ibrutinib is a BTK inhibitor. That’s a Bruton’s tyrosine kinase inhibitor,” Dr. Sairah Ahmed, associate professor in the Department of Lymphoma/Myeloma, Division of Cancer Medicine, at MD Anderson Cancer Center tells SurvivorNet.
Read More BTK inhibitors are a type of drug known as cell signal inhibitors. All cells, including cancer cells, receive signals that help them divide and grow. Imbruvica targets a protein called BTK, which is part of a pathway that helps cancer cells multiply and spread. By blocking BTK, this drug prevents cancer cells from growing.
Imbruvica comes as a pill that you take once a day. The dosage your doctor prescribes is based on the type of lymphoma you have.
Who Can Take Imbruvica?
This drug may be an option for you if you have one of these types of lymphoma:
- Mantle cell lymphoma (MCL)
- Chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL)
- Marginal zone lymphoma (MZL)
- Lymphoplasmacytic lymphoma (LPL)
It’s also being used experimentally in some people with diffuse large B-cell lymphoma. Typically, you’ll only get this drug after you’ve already tried another treatment and your cancer has come back, or relapsed. “Most often if you’re going to receive ibrutinib, it’s going to be when lymphoma has returned when you’re talking about diffuse large B-cell lymphoma,” Dr. Ahmed says.
A couple of the doctors she works with at MD Anderson are studying Imbruvica combined with chemotherapy and other medicines as the first treatment for lymphoma. One of these trials is combining Imbruvica with chemotherapy and the immunotherapy drug, rituximab (Rituxan), a combination that doctors call “chemoimmunotherapy.” Dr. Ahmed tells SurvivorNet the researchers have had “excellent results” so far when using this combination on diffuse large B-cell lymphoma.
Other clinical trials are investigating Imbruvica in combination with chemotherapy as a first treatment for a type of diffuse large B-cell lymphoma called non-germinal, or non-GCB cancer. Those studies haven’t shown enough improvement for the FDA to approve Imbruvica as an initial treatment for this cancer type.
Dr. Ahmed believes that the combination of immunotherapy, other new treatments, and conventional chemotherapy “is what we’re going to see in the future.” Doctors will continue to fine-tune the doses and monitor for side effects as they look for the most effective ways to combine these cancer drugs.
What Are the Side Effects?
Overall, Imbruvica is very well tolerated, Dr. Ahmed says. Just like any other cancer drug, it can cause side effects, though. The most common ones are:
- Diarrhea
- Fatigue
- Bruising and bleeding
- Low blood cell counts
- Joint and muscle pain
- Increased risk for infections
It can also cause irregular heart rhythms (arrhythmias). Often, that’s more of a problem for people who started out with heart problems, but even those who haven’t had a heart issue in the past can develop an arrhythmia for the first time while taking Imbruvica.
“That’s why, when it’s given, even though it’s an oral chemotherapy, it needs to be monitored closely,” Dr. Ahmed says. “Patients still need to have bloodwork and see their oncologist once a month as they get that drug.”
If you notice any side effects while on cancer treatment, it’s important to mention them to your doctor. You might need an adjustment in dose, or, if the side effect is serious enough, to go off the drug entirely. We now have other drugs in the same class as Imbruvica — BTK inhibitors — but with different side effect profiles that may be options if you have intolerable side effects from Imbruvica.
Learn more about SurvivorNet's rigorous medical review process.
Dr. Sairah Ahmed is associate professor in the Department of Lymphoma/Myeloma, Division of Cancer Medicine, at MD Anderson Cancer Center in Houston, Texas. She is board-certified in internal medicine, hematology, and medical oncology. Read More
