March 3, 2021
Acalabrutinib has the edge in safety
- Acalabrutinib (brand name: Calquence) is one of the second-generation BTK inhibitors, which also include zanabrutinib and tirabrutinib
- These drugs have changed the treatment paradigm for CLL
- Acalabrutinib has a lower incidence of chronic adverse events compared to other drugs in this class
Bruton tyrosine kinase (BTK) inhibitors have proven themselves highly effective for both treatment-naïve and relapsed/refractory chronic lymphocytic leukemia (CLL). The first-generation BTK inhibitor ibrutinib was followed by second-generation drugs such as acalabrutinib (brand name: Calquence), zanubrutinib and tirabrutinib, which have all shown good long-term efficacy and safety.
These drugs have revolutionized treatment of this cancer. “They have actually changed our mindset about how we treat CLL,” Dr. Sikander Ailawadhi, hematologist-oncologist and professor of medicine at the Mayo Clinic in Jacksonville, Fla., tells SurvivorNet Connect.
Rather than receive a fixed number of treatments over a specified period of time, patients now remain on treatment for as long as it works — or for as long as they can tolerate it. “Long-term tolerability, patient compliance, their ability to stick to those treatments becomes immensely important. And in my mind, that is where the subsequent generation BTK inhibitors come into play,” Dr. Ailawadhi says.
It’s still unclear which of these second-generation therapeutics is most effective or provides the deepest response. Acalabrutinib’s advantage is its safety relative to the other drugs in this class. It has a lower incidence of chronic adverse events, including atrial fibrillation. “That, in my mind, is the biggest difference. That the drug is better tolerated,” he adds.