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.
Ixazomib citrate is a novel oral medicinal product that is already licensed in the UK for the treatment of MM in patients who have received at least one prior therapy (in combination with lenalidomide and dexamethasone). Ixazomib citrate offers the potential advantage over similar medicines in its class of being more effective in its anticancer activity, less toxic (reduced side effects) and more convenient to administer (through its weekly oral dosing). If approved as maintenance therapy following stem cell transplant in newly diagnosed MM patients, ixazomib citrate has the potential to improve the success rates of treatment by improving progression free survival and overall survival as well as presenting a more convenient way of administration that allows long term administration and improvement of patients’ quality of life.