TY - JOUR
T1 - Cardiovascular Toxicities of BTK Inhibitors in Chronic Lymphocytic Leukemia
T2 - JACC: CardioOncology State-of-the-Art Review
AU - Quartermaine, Cooper
AU - Ghazi, Sanam M.
AU - Yasin, Aneeq
AU - Awan, Farrukh T.
AU - Fradley, Michael
AU - Wiczer, Tracy
AU - Kalathoor, Sujay
AU - Ferdousi, Mussammat
AU - Krishan, Satyam
AU - Habib, Alma
AU - Shaaban, Adnan
AU - Kola-Kehinde, Onaopepo
AU - Kittai, Adam S.
AU - Rogers, Kerry A.
AU - Grever, Michael
AU - Ruz, Patrick
AU - Bhat, Seema
AU - Dickerson, Tyler
AU - Byrd, John C.
AU - Woyach, Jennifer
AU - Addison, Daniel
N1 - Publisher Copyright:
© 2023
PY - 2023/10
Y1 - 2023/10
N2 - Over the past decade, the treatment landscape of chronic lymphocytic leukemia (CLL) has dramatically changed, shifting from cytotoxic chemotherapy to targeted therapies. Bruton's tyrosine kinase (BTK) inhibitors have revolutionized the treatment of CLL and are increasingly applied in many other malignancies. However, ibrutinib, the first BTK inhibitor approved, is associated with serious toxicities, including atrial fibrillation in up to 38% of patients, ventricular arrhythmias, and other cardiovascular toxicities. Emerging data suggest several newer BTK inhibitors (eg, acalabrutinib, zanubrutinib) are still associated with cardiotoxic risks. This review examines the current state of evidence, including incidence rates, risk factors, mechanisms, and management strategies of cardiovascular toxicities with BTK inhibitors and other CLL therapies. We specifically focus on atrial fibrillation, ventricular arrhythmias/sudden death, hypertension, heart failure, bleeding, and stroke. We also touch on other emerging BTK therapies (eg, pirtobrutinib). Finally, we highlight key unanswered questions and future directions of research.
AB - Over the past decade, the treatment landscape of chronic lymphocytic leukemia (CLL) has dramatically changed, shifting from cytotoxic chemotherapy to targeted therapies. Bruton's tyrosine kinase (BTK) inhibitors have revolutionized the treatment of CLL and are increasingly applied in many other malignancies. However, ibrutinib, the first BTK inhibitor approved, is associated with serious toxicities, including atrial fibrillation in up to 38% of patients, ventricular arrhythmias, and other cardiovascular toxicities. Emerging data suggest several newer BTK inhibitors (eg, acalabrutinib, zanubrutinib) are still associated with cardiotoxic risks. This review examines the current state of evidence, including incidence rates, risk factors, mechanisms, and management strategies of cardiovascular toxicities with BTK inhibitors and other CLL therapies. We specifically focus on atrial fibrillation, ventricular arrhythmias/sudden death, hypertension, heart failure, bleeding, and stroke. We also touch on other emerging BTK therapies (eg, pirtobrutinib). Finally, we highlight key unanswered questions and future directions of research.
KW - Bruton's tyrosine kinase inhibitors
KW - acalabrutinib
KW - atrial fibrillation
KW - cardio-oncology
KW - ibrutinib
KW - sudden death
KW - zanubrutinib
UR - http://www.scopus.com/inward/record.url?scp=85173774643&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85173774643&partnerID=8YFLogxK
U2 - 10.1016/j.jaccao.2023.09.002
DO - 10.1016/j.jaccao.2023.09.002
M3 - Review article
C2 - 37969643
AN - SCOPUS:85173774643
SN - 2666-0873
VL - 5
SP - 570
EP - 590
JO - JACC: CardioOncology
JF - JACC: CardioOncology
IS - 5
ER -