Clinician Perspective on Once-Daily Zanubrutinib Dosing for B-Cell Malignancies at a Single Center

Zanubrutinib, a next-generation, irreversible, highly potent, and selective Bruton tyrosine kinase inhibitor, is approved by the U.S. Food and Drug Administration to treat patients with B-cell malignancies in 2 dose regimens: 160 mg twice daily (BID) and 320 mg once daily (QD). Although the 160 mg BID regimen was the recommended phase 2 dose and more widely used in clinical trials, both regimens have yielded similar efficacy and safety. Currently, there is a lack of reported clinician experience on zanubrutinib QD versus BID practice patterns. This article provides perspectives on zanubrutinib dosing through interviews with 2 clinical care professionals at the Maryland Oncology Hematology Center, based on their experiences treating patients with Waldenström macroglobulinemia (WM) or chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). Zanubrutinib QD is the preferred regimen for some physicians and pharmacists, as it may improve treatment adherence within weeks after initiation compared with BID dosing. According to the clinician interviews provided in this report, patients have reported positive experiences with QD dosing, including a reduced administration burden in those with complicated polypharmacy. Thus, observations from this single center indicate that the zanubrutinib QD regimen may offer benefits to both patients with WM or CLL/SLL and their clinical care teams and should be considered in patients receiving zanubrutinib.