SOHO 2023 | The MAHOGANY trial: emerging roles for BTKis in indolent lymphoma
Loretta Nastoupil, MD, The University of Texas MD Anderson Cancer Center, Houston, TX, comments on the emerging role of BTK inhibitors in the treatment of indolent lymphomas, particularly follicular lymphoma (FL) and marginal zone lymphoma (MZL). Dr Nastoupil highlights the findings of the SELENE and ROSEWOOD studies (NCT01974440; NCT03332017), and introduces the MAHOGANY trial (NCT05100862). This interview took place at the Eleventh Annual Meeting of the Society of Hematologic Oncology (SOHO 2023) held in Houston, TX.
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Transcript (edited for clarity)
The only other thing that’s out there is where do BTK inhibitors have a role in follicular lymphoma specifically? Recently we saw the negative results of the SELENE study, which was ibrutinib in combination with chemoimmunotherapy, but with ROSEWOOD, which was obinutuzumab in combination with zanubrutinib versus obinutuzumab monotherapy, randomized Phase II, clearly saw efficacy with zanubrutinib in combination with obinutuzumab, much more so than obinutuzumab monotherapy...
The only other thing that’s out there is where do BTK inhibitors have a role in follicular lymphoma specifically? Recently we saw the negative results of the SELENE study, which was ibrutinib in combination with chemoimmunotherapy, but with ROSEWOOD, which was obinutuzumab in combination with zanubrutinib versus obinutuzumab monotherapy, randomized Phase II, clearly saw efficacy with zanubrutinib in combination with obinutuzumab, much more so than obinutuzumab monotherapy. And the safety was pretty favorable. So that now opens the door to, well, maybe there should be a role for BTK inhibitors, specifically in follicular lymphoma. So the MAHOGANY is a randomized Phase III of zanubrutinib in combination with obinutuzumab versus R-squared in relapsed follicular. And there’s a separate cohort of marginal zone lymphoma patients which is zanubrutinib plus rituximab again versus R-squared. So that’s a large multicenter Phase III study that’s launched. And if that’s a positive study, then that might bring a new sort of mechanism of action into the treatment armamentarium for indolent lymphomas.
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