Inhibitors of B-cell receptor signaling may be effective for treatment of vitreoretinal lymphomas

Arman Mashayehi

PHILADELPHIA — New drugs that inhibit B-cell receptor signaling pathways can be an effective treatment for B-cell malignancies, according to a speaker here.

“B-cell receptor signaling is also crucial for survival and growth of malignant B cells. Leukemias and lymphomas rely on this pathway for their growth. I want to emphasize that there is a family of drugs that can inhibit Bruton’s tyrosine kinase. The most well known is ibrutinib,” Arman Mashayekhi, MD, said at the Wills Eye Conference.

Traditional treatments for vitreoretinal lymphomas include external beam radiation, intravitreal chemotherapy and vitrectomy. Stem cell transplantation has also been used, but it is mainly used for patients who have refractory central nervous lymphoma rather than isolated vitreoretinal lymphoma, he said.

B-cell receptor signaling inhibitors are a new family of drugs that can potentially be used to treat these lymphomas. Ibrutinib is likely the most well-known drug in this family and is given orally once daily. It can penetrate the blood-brain barrier and most likely the blood-ocular barrier as well, Mashayekhi said.

It has been found that between 60% to 80% of patients with vitreoretinal lymphoma also have a mutation in their myeloid differentiation primary response protein 88 (MYD88), and it has been shown that tumors that have this mutation are more responsive to a drug such as ibrutinib.

“If you find a MYD88 mutation, you can expect the tumor will show a response to ibrutinib,” Mashayekhi said. – by Robert Linnehan

Reference:

Mashayekhi A. Treatment for vitreoretinal lymphoma. Presented at: Wills Eye Conference; March 7-9, 2019; Philadelphia.

Disclosure: Mashayekhi reports no relevant financial disclosures.