Mechanisms of action of ibrutinib, ruxolitinib, and belumosudil, and their role in cGvHD treatment

The GvHD Hub was pleased to speak with Robert Zeiser, Medical Center – University of Freiburg, Freiburg, DE, about the mechanisms of action of ibrutinib, ruxolitinib, and belumosudil, and their role in chronic graft-versus-host disease (cGvHD) treatment.

Zeiser begins by providing an overview of cGvHD and its implications for patients. This is followed by a discussion on three recently approved drugs, ibrutinib, ruxolitinib, and belumosudil, including their mechanisms of action in relation to cGvHD (Figure 1). Finally, Zeiser summarizes the clinical activity and recent trials investigating these drugs.

Figure 1. The mechanisms of action of ibrutinib, belumosudil, and ruxolitinib, and their treatment effects in cGvHD*

BCR, B-cell receptor; cGvHD, chronic graft-versus-host disease; ECM, extracellular matrix; IFN, interferon; IL, interleukin; TCR, T-cell receptor; Th17 cells, T helper 17 cells; T reg cells, regulatory T cells.
*Adapted from Zeiser et al.¹