Managing Adverse Events and Sequencing Therapies

Managing the adverse effects of BTK inhibitors is crucial, particularly cardiac toxicities and the risk of infections, as these drugs can lead to immunosuppression. When a patient progresses on a BTK inhibitor, it is essential to avoid moving to another covalent BTK inhibitor, as this can perpetuate resistance; instead, non-covalent options should be considered. Physicians employ numerous strategies to monitor and mitigate side effects, including cardiac assessments and offering immunoglobulin therapy for patients experiencing infections. Furthermore, the approach to sequencing therapies for relapsed patients hinges on prior treatments, with BTK inhibitors remaining standard options post-chemotherapy, while alternative therapies like CAR T-cell therapy or non-covalent BTK inhibitors are considered based on individual patient responses to previous therapies.