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miniCHOP + orelabrutinib is an investigational combination regimen consisting of a reduced-dose chemotherapy backbone (miniCHOP) and the second-generation Bruton's tyrosine kinase (BTK) inhibitor orelabrutinib. It is primarily being evaluated for the treatment of newly diagnosed patients with the MCD subtype of diffuse large B-cell lymphoma (DLBCL). The MCD subtype is characterized by mutations in MYD88 and CD79B, which drive chronic active B-cell receptor signaling, making these tumors sensitive to BTK inhibition. Orelabrutinib is a potent, irreversible, covalent small molecule inhibitor with high selectivity for BTK. The miniCHOP component typically includes cyclophosphamide, doxorubicin, vincristine, and prednisone at reduced doses to improve tolerability, particularly in elderly or frail patients. The regimen is often administered as induction therapy followed by orelabrutinib monotherapy maintenance.
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