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Opinion|Videos|February 7, 2025

Discontinuing Versus Switching BTK Inhibitors for Toxicity

Panelists discuss how data from Mansour and colleagues suggesting potential Bruton tyrosine kinase (BTK) inhibitor discontinuation after 2+ years of therapy opens up new treatment strategy considerations, with decisions between discontinuation vs switching to alternative BTK inhibitor (BTKi) therapy being influenced by factors such as depth and duration of response, toxicity severity, patient preferences regarding adverse effects and treatment schedules, and quality-of-life considerations.

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Video content above is prompted by the following:

  • The ASH abstract by Mansour and colleagues suggests that for patients who have been on BTK inhibitors for more than 2 years, discontinuing therapy and observing the patient off-treatment might be an option, rather than switching to another BTKi immediately. What is your interpretation of this approach, and what factors would influence your decision to discontinue BTKi therapy due to toxicity instead of switching to an alternative BTKi?
  • How should patient preferences regarding adverse effects, treatment schedules, and efficacy trade-offs influence the decision to switch or continue BTKi therapy?
  • Consider reviewing the abstract by Ailawadhi and colleagues on patient preferences for BTKi.

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