{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T07:07:12Z","timestamp":1789456032237,"version":"build-2803163510"},"reference-count":90,"publisher":"Wiley","issue":"17","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Cellular Molecular Medi"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Bruton tyrosine kinase inhibitors (BTKis) have been employed in the treatment of mantle cell lymphoma (MCL). However, direct comparisons of ibrutinib, zanubrutinib, and acalabrutinib across treatment\u2010na\u00efve (TN) and relapsed\/refractory (R\/R) MCL remain limited. This meta\u2010analysis was intended to evaluate their efficacy, addressing critical gaps in clinical decision\u2010making. We systematically searched PubMed, Embase, and Cochrane up to January 2025 for studies (RCT\/single\u2010arm) assessing the efficacy of BTKis in MCL patients. Among 70 studies, the pooled CR rate in the TN group was higher than that in the R\/R group (76.5% vs. 43.2%). Among TN patients, the CR rate of the regimen incorporating zanubrutinib (95.2% [95% CI 0.893, 1.000]) was significantly higher than that of the regimens containing acalabrutinib or ibrutinib (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0042). In the R\/R group, the BTKi + anti\u2010CD20 monoclonal antibody + small\u2010molecular therapy group presented a better CR rate (68.3% [95% CI 0.546, 0.820];\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0001). When comparing the monotherapy efficacy of three BTKis in R\/R MCL, the results indicated that acalabrutinib exhibited a higher CR rate (43.2% [95% CI 0.339, 0.525]) than zanubrutinib or ibrutinib. In addition, zanubrutinib\u2010based therapy exhibited a lower pooled rate of haematological toxicities compared to the other two BTKi therapies. This work resolved critical uncertainties in BTKi selection for MCL, demonstrating acalabrutinib's and zanubrutinib's first\u2010line potential, leading to a meaningful improvement in response rate and a manageable safety profile. Chemotherapy\u2010free regimen can partially overcome the traditionally unfavourable prognosis associated with R\/R MCL. These results provide a roadmap for optimizing MCL therapy. Chemotherapy\u2010free regimens for MCL based on BTKis warrant further validation in RCTs. These findings may advocate for updated guidelines prioritizing zanubrutinib and acalabrutinib in clinical practice.\n                  <\/jats:p>","DOI":"10.1111\/jcmm.71340","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T04:24:22Z","timestamp":1788409462000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Efficacy of\n                    <scp>BTK<\/scp>\n                    Inhibitors in Treatment\u2010Na\u00efve and Relapsed\/Refractory Mantle Cell Lymphoma: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5765-1344","authenticated-orcid":false,"given":"Fangfei","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Hematology Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology  Wuhan Hubei China"},{"name":"Immunotherapy Research 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College, Huazhong University of Science and Technology  Wuhan Hubei China"},{"name":"Immunotherapy Research Center for Hematologic Diseases of Hubei Province  Wuhan Hubei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6959-7077","authenticated-orcid":false,"given":"Wei","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Hematology Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology  Wuhan Hubei China"},{"name":"Immunotherapy Research Center for Hematologic Diseases of Hubei Province  Wuhan Hubei 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