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General Updates | The potential role of rilzabrutinib in the treatment of ITP

Hanny Al-Samkari, MD, Massachusetts General Hospital, Boston, MA, comments on the potential role of rilzabrutinib, a novel BTK inhibitor, in the treatment landscape of immune thrombocytopenia (ITP), highlighting the promising results of the Phase III LUNA3 trial (NCT04562766) investigating this agent. The findings from this study suggest rilzabrutinib is an attractive treatment option for patients with persistent or chronic ITP. However, Dr Al-Samkari also hopes for additional data on the efficacy of this agent in earlier lines of therapy and in combination with other drugs. This interview took place virtually.

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Transcript

Rilzabrutinib was recently shown in the Phase III pivotal LUNA3 study to be superior to placebo in treating ITP, with patients on rilzabrutinib much more likely to develop a durable response to the medication. Rilzabrutinib is a twice-daily oral drug, a BTK inhibitor, a very targeted BTK inhibitor that targets BTK to a degree that’s much more specific than older generation BTK inhibitors like ibrutinib and acalabrutinib, and so does not inhibit platelet function...

Rilzabrutinib was recently shown in the Phase III pivotal LUNA3 study to be superior to placebo in treating ITP, with patients on rilzabrutinib much more likely to develop a durable response to the medication. Rilzabrutinib is a twice-daily oral drug, a BTK inhibitor, a very targeted BTK inhibitor that targets BTK to a degree that’s much more specific than older generation BTK inhibitors like ibrutinib and acalabrutinib, and so does not inhibit platelet function. And so rilzabrutinib, I think, is going to provide another important treatment option for patients with ITP. The data that we have right now is in the third line or later, which certainly the drug has promise there, and it has worked for many patients where other therapies have all failed, which provides, I think, a really attractive treatment option for people that have failed thrombopoietin receptor agonists and rituximab and possibly fostamatinib. I’m hopeful to see additional data with rilzabrutinib earlier in the course of ITP and see how the response rates look in patients receiving the drug in perhaps second line and maybe even in combination therapy in first line. I think that there are opportunities, given that the mechanism of action of rilzabrutinib is really broad across the immune system, not just inhibiting the maturation of B-cells, but impacts on phagocytes and other aspects of immunity.

 

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Disclosures

Consultancy: Amgen, Alnylam, Alpine, Agios, Takeda, Pharmacosmos, Sanofi, Sobi, Novartis; Research funding to institution: Amgen, Agios, Novartis, Sobi, Vaderis.