CTNI-60. PROMISING EFFICACY SIGNAL IN SECONDARY CNS LYMPHOMA PATIENTS TREATED WITH EMAVUSERTIB AND IBRUTINIB

Abstract Secondary central nervous system lymphoma (SCNSL) is defined as the diagnosis of CNS lymphoma diagnosed concurrently with systemic lymphoma or after prior treatment. Due to the poor prognosis associated with SCNSL, the lack of randomized trial data, and the need for international consensus guidelines, there is a high unmet need for effective therapy options for SCNSL. Here we present safety and efficacy data on 2 SCNSL patients treated with the combination of emavusertib and ibrutinib. Both patients had directly progressed on their prior BTKi treatment. One patient achieved an unconfirmed complete response (CRu) and remained on treatment for over 4 mos, while the other patient maintained stable disease (SD) with a 38% reduction in disease burden from baseline and was on treatment for more than 8 mos. The patient with a durable SD, who received 5 prior lines of therapy along with an ASCT, presented with 3 related AEs Grade ≥ 3 that were reversible and manageable. These included elevated ALT, AST, and bilirubin levels that resolved. The patient received emavusertib 300 mg BID and ibrutinib 560 mg QD. The CRu patient received 6 prior lines of therapy and experienced CK elevation, fatigue, hypoglycemia, sepsis, urinary retention, neutropenia, and constipation that resolved with either a dose reduction and/or supportive care. The initial dose for this patient was 150 mg emavusertib BID and ibrutinib 560 mg QD. Subsequently, the dose of emavusertib was decreased to 150 mg BID due to Grade 4 neutropenia, then increased to 200 mg AM and 150 mg PM once resolved. This patient achieved CRu within 60 days on treatment. The 2 patients presented here are supportive data for using the combination of emavusertib and ibrutinib in SCNSL.