Current Hematologic Malignancy Reports

, Volume 9, Issue 1, pp 44–49 | Cite as

Bruton’s Tyrosine Kinase (BTK) Inhibitors in Clinical Trials

  • Jan A. BurgerEmail author
Chronic Leukemias (S O’Brien, Section Editor)


BTK is a cytoplasmic, non-receptor tyrosine kinase that transmits signals from a variety of cell-surface molecules, including the B-cell receptor (BCR) and tissue homing receptors. Genetic BTK deletion causes B-cell immunodeficiency in humans and mice, making this kinase an attractive therapeutic target for B-cell disorders. The BTK inhibitor ibrutinib (PCI-32765, brand name: Imbruvica) demonstrated high clinical activity in B-cell malignancies, especially in patients with chronic lymphocytic leukemia (CLL), mantle cell lymphoma (MCL), and Waldenstrom's macroglobulinemia (WM). Therefore, ibrutinib was granted a ‘breakthrough therapy’ designation for these indications and was recently approved for the treatment of relapsed MCL by the U.S. Food and Drug Administration. Other BTK inhibitors in earlier clinical development include CC-292 (AVL-292), and ONO-4059. In CLL and MCL, ibrutinib characteristically induces redistribution of malignant B cells from tissue sites into the peripheral blood, along with rapid resolution of enlarged lymph nodes and a surge in lymphocytosis. With continuous ibrutinib therapy, growth- and survival-inhibitory activities of ibrutinib result in the normalization of lymphocyte counts and remissions in a majority of patients. This review discusses the clinical advances with BTK inhibitor therapy, as well as its pathophysiological basis, and outlines perspectives for future use of BTK inhibitors.


Chronic lymphocytic leukemia CLL Microenvironment B cell receptor BCR BTK ibrutinib CC-292 



This manuscript was supported by a Leukemia & Lymphoma Society Scholar Award in Clinical Research, a Cancer Prevention and Research Institute of Texas (CPRIT) grant, and the MD Anderson CLL Moon Shot Program.

Compliance with Ethics Guidelines

Conflict of Interest

Dr. Jan Burger has received grants from Pharmacyclics, Gilead, and Noxxon.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of LeukemiaThe University of Texas MD Anderson Cancer CenterHoustonUSA

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