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Zanubrutinib versus ibrutinib in Waldenström macroglobulinaemia

Zanubrutinib demonstrated a non-significant improvement in response rate and lower rates of several adverse events compared with ibrutinib in patients with Waldenström macroglobulinaemia (WM).

In the phase 3 ASPEN trial, presented by Prof. Meletios Dimopoulos (University of Athens, Greece), treatment with the two Bruton's tyrosine kinase (BTK) inhibitors, zanubrutinib and ibrutinib, was compared head-to-head in patients with WM [1]. Zanubrutinib has greater selectivity for BTK inhibition when compared with ibrutinib, which has off-target effects on expression of EGFR, FGR, FRK, HER2, HER4, ITK, JAK 3, LCK and TEC, which, for example, are thought to exacerbate diarrhoea, thrombocytopenia, bleeding, atrial fibrillation, rash and fatigue [2].

ASPEN enrolled 201 WM patients with a confirmed *MYD88* mutation, and 28 patients with wildtype *MYD88*. WM patients with *MYD88* muta...



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