The FDA has granted accelerated approval to the B-cell lymphoma 2 (BCL-2) inhibitor sonrotoclax (Beqalzi – BeOne Medicines) for treatment of relapsed or refractory mantle cell lymphoma (MCL) in adults who received ≥2 prior lines of systemic therapy, including a Bruton's tyrosine kinase (BTK) inhibitor (e.g., pirtobrutinib [Jaypirca]), acalabrutinib [Calquence], or zanubrutinib [Brukinsa]). Sonrotoclax is the first BCL-2 inhibitor to be approved in the US for this indication. The BCL-2 inhibitor venetoclax (Venclexta) has been used off label for third-line treatment of MCL.

The Bruton's tyrosine kinase (BTK) inhibitor zanubrutinib (Brukinsa), which was previously approved by the FDA for treatment of mantle cell lymphoma, Waldenström's macroglobulinemia, and relapsed or refractory marginal zone lymphoma, has now been approved for treatment of chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) in adults. The BTK inhibitors ibrutinib (Imbruvica) and acalabrutinib (Calquence) were approved earlier for treatment of CLL and SLL.

The Bruton's tyrosine kinase (BTK) inhibitor pirtobrutinib (Jaypirca – Lilly) has received accelerated approval from the FDA for treatment of relapsed or refractory mantle cell lymphoma (MCL) in adults who received ≥2 prior lines of systemic therapy, including a BTK inhibitor. Accelerated approval was based on the response rate. The BTK inhibitors ibrutinib (Imbruvica), acalabrutinib (Calquence), and zanubrutinib (Brukinsa) are also approved for treatment of MCL.