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Orelabrutinib + methotrexate is an investigational combination regimen that pairs orelabrutinib, an oral, highly selective, second-generation Bruton's tyrosine kinase (BTK) inhibitor, with methotrexate, a folate analog metabolic inhibitor and cytotoxic chemotherapy (typically administered at high doses, HD-MTX). Orelabrutinib is designed to cross the blood-brain barrier and achieve high concentrations in the cerebrospinal fluid (CSF), making this combination particularly suitable for treating central nervous system (CNS) malignancies. The regimen is primarily being evaluated, often in combination with rituximab (forming the ORM or R-MO regimen), as an induction therapy for newly diagnosed or relapsed/refractory primary central nervous system lymphoma (PCNSL) and other B-cell malignancies of the CNS.
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