BTK inhibitors approved in Canada for CLL: Strategies for adverse event management

Abstract

Bruton tyrosine kinase (BTK) inhibitors are an effective therapy for the treatment of chronic lymphocytic leukemia (CLL), particularly in patients who present with high-risk features. The first-in-class BTK inhibitor, ibrutinib, is generally tolerable. However, unique adverse events (AEs) of concern, including cardiovascular toxicity and bleeding have been observed, prompting the development of next-generation inhibitors, such as acalabrutinib, with an improved safety profile. Nevertheless, as BTK inhibitors are given as a continuous therapy, and therapy interruptions have been associated with decreased efficacy, appropriate management of AEs related to any agent within this class is critical for optimizing outcomes. This paper will serve as a learning resource for Canadian oncology nurses on the BTK inhibitors currently approved in Canada for the treatment of CLL. It includes a description of the unique safety profiles of the BTK inhibitors and suggests strategies for monitoring and managing related AEs.