ASH 2022 | BRUIN MCL-321: pirtobrutinib vs investigator choice of BTK inhibitor in BTK inhibitor-naive MCL

One thing we learned from the initial BRUIN clinical trial was that in mantle cell lymphoma, that even patients who had progressed on a covalent BTK inhibitor, actually got clinical benefit from pirtobrutinib, a non-covalent BTK inhibitor. So this begs the question, what is the best BTK inhibitor to give in mantle cell lymphoma? And so there’s now a head-to-head clinical trial in relapsed mantle cell lymphoma that compares pirtobrutinib to sort of dealer’s choice. So the dealer’s choice are any of the approved covalent inhibitors in the United States, so acalabrutinib, zanubrutinib, ibrutinib; and so you get randomized to one of these two arms.

And at this current moment, we’re enrolling patients on this trial. It’s a global study, but I think it’s going to really provide a lot of information both about how do BTK inhibitors work in mantle cell and is a non-covalent approach, perhaps a better first BTK inhibitor to give for relapsed mantle cell lymphoma. Time will tell, but I think it’s a very bold study and I think no matter what we’re going to learn a lot about mantle cell in these drugs.