Waldenstrom’s Macroglobulinaemia (WM) is a rare type of slow developing cancer which affects a type of cell of the immune system called B-cells. It is caused when abnormal B-cells build up in the bone marrow and other parts of the immune system which can block other normal blood cells from being produced. The abnormal B-cells also release large amounts of a protein called IgM which can build up in the blood making it thicker. People can live with WM for many years and will only usually receive treatment when the disease of symptoms begin to worsen. Treatments which are currently available include chemotherapy, stem cell transplants and plasma replacement.
Zanubrutinib is an oral drug taken twice a day which is currently in clinical trials for the treatment of patients with WM. Zanubrutinib works by blocking a protein called Bruton’s Tyrosine Kinase (BTK) in the abnormal B-cells which prevents the growth of these cells. As this drug specifically targets the abnormal B-cells, unlike chemotherapy drugs, this type of drug may provide fewer side effects than existing treatment for WM.
Nivolumab is a type of immunotherapy that is currently licensed in the UK for the treatment of several types of advanced cancers such as melanoma, non‐small cell lung cancer, and kidney cancer. It blocks a protein called programmed death-1 (PD-1), which is found on the surface of a type of immune cells called T-cells. Blocking PD-1 stimulates the T-cells to kill the cancer cells. Temozolomide in combination with radiotherapy is currently licensed in the UK for newly diagnosed glioblastoma in adults. The addition of nivolumab to temozolomide and radiotherapy will potentially offer an additional first line treatment option for adult patients who are newly diagnosed MGMT-methylated glioblastoma.