Would you consider replacing ibrutinib with acalabrutinib or zanubrutinib in the TRIANGLE regimen for MCL in a patient with atrial fibrillation or high risk coronary syndromes who is otherwise fit for aggressive induction therapy?

Generally, if a patient is significantly symptomatic or intolerant due to atrial fibrillation, or other arrhythmia or even heart failure, it is reasonable to consider a next generation BTKI (acalabrutinib or zanubrutinib). As a cardiologist, I will defer to my cancer colleagues on efficacy across ad...