Bruton's Tyrosine Kinase Inhibitors for the Treatment of Waldenström's Macroglobulinaemia: A Canadian Perspective
Bibliographic record
Abstract
C onventional chemoimmunotherapy using bendamustine and rituximab is considered the frontline treatment of choice for Waldenström's macroglobulinaemia (WM) in many countries, including Canada.Despite its efficacy, this regimen can be challenging for many patients, and the oral Bruton's tyrosine kinase (BTK) inhibitors have emerged as alternative standard-of-care options.Ibrutinib, the first BTK inhibitor approved for WM, is highly active and is able to maintain years of disease control with continuous therapy.Though generally well tolerated, discontinuations due to adverse events and treatment fatigue with long-term use can occur.Newer selective BTK inhibitors such as zanubrutinib and acalabrutinib are promising in WM, demonstrating both efficacy even in challenging populations and the potential for improved toxicity over ibrutinib.As we enter an era of genomic-based treatment stratification within a publicly funded healthcare system in Canada, we review how the different BTK inhibitors and chemoimmunotherapy fit into the current Canadian treatment landscape for WM.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.004 | 0.007 |
| Insufficient payload (model declined to judge) | 0.011 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".