Clinician Perspective on Once-Daily Zanubrutinib Dosing for B-Cell Malignancies at a Single Center.

Zanubrutinib, a next-generation, irreversible, highly potent, and selective Bruton tyrosine kinase inhibitor, is approved by the U.S. Food and Drug Administration to treat patients with B-cell malignancies in 2 dose regimens: 160 mg twice daily (BID) and 320 mg once daily (QD). Although the 160 mg BID regimen was the recommended phase 2 dose and more widely used in clinical trials, both regimens have yielded similar efficacy and safety. Currently, there is a lack of reported clinician experience on zanubrutinib QD versus BID practice patterns. This article provides perspectives on zanubrutinib dosing through interviews with 2 clinical care professionals at the Maryland Oncology Hematology Center, based on their experiences treating patients with Waldenström macroglobulinemia (WM) or chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). Zanubrutinib QD is the preferred regimen for some physicians and pharmacists, as it may improve treatment adherence within weeks after initiation compared with BID dosing. According to the clinician interviews provided in this report, patients have reported positive experiences with QD dosing, including a reduced administration burden in those with complicated polypharmacy. Thus, observations from this single center indicate that the zanubrutinib QD regimen may offer benefits to both patients with WM or CLL/SLL and their clinical care teams and should be considered in patients receiving zanubrutinib.

Experimental DNA Demethylation Associates with Changes in Growth and Gene Expression of Oak Tree Seedlings.

Epigenetic modifications such as DNA methylation, where methyl groups are added to cytosine base pairs, have the potential to impact phenotypic variation and gene expression, and could influence plant response to changing environments. One way to test this impact is through the application of chemical demethylation agents, such as 5-Azacytidine, which inhibit DNA methylation and lead to a partial reduction in DNA methylation across the genome. In this study, we treated 5-month-old seedlings of the tree, Quercus lobata, with foliar application of 5-Azacytidine to test whether a reduction in genome-wide methylation would cause differential gene expression and change phenotypic development. First, we demonstrate that demethylation treatment led to 3-6% absolute reductions and 6.7-43.2% relative reductions in genome-wide methylation across CG, CHG, and CHH sequence contexts, with CHH showing the strongest relative reduction. Seedlings treated with 5-Azacytidine showed a substantial reduction in new growth, which was less than half that of control seedlings. We tested whether this result could be due to impact of the treatment on the soil microbiome and found minimal differences in the soil microbiome between two groups, although with limited sample size. We found no significant differences in leaf fluctuating asymmetry (i.e., deviations from bilateral symmetry), which has been found in other studies. Nonetheless, treated seedlings showed differential expression of a total of 23 genes. Overall, this study provides initial evidence that DNA methylation is involved in gene expression and phenotypic variation in seedlings and suggests that removal of DNA methylation affects plant development.