Background: Treatment options after Bruton’s tyrosine kinase inhibitors (BTKi) failure in Waldenstrom macroglobulinaemia are limited. Methods: We retrospectively analysed the use of bortezomib after BTKi failure in 17 patients who were heavily pre-treated and chemotherapy-exposed at our centre between 2018 and 2025. Results: Reasons for BTKi failure were disease progression (59%) and intolerance (41%). At bortezomib initiation, the median age was 73 years and two patients experienced grade 1–2 neuropathy. The best overall response rate (ORR) was 88%. At a median follow up of 39 months (interquartile range 35–78), median treatment-free survival and overall survival were 18 (95% confidence interval CI 13–22) and 22 (95% CI 17–45) months, respectively. Conclusion: Bortezomib may be efficacious in patients who experience BTKi failure.
Khwaja et al. (Sat,) studied this question.