Dr. Barrientos on the Role of Acalabrutinib in CLL

Jacqueline C. Barrientos, MD, associate professor, The Feinstein Institute for Medical Research, Northwell Health, discusses the role of acalabrutinib (Calquence) for patients with chronic lymphocytic leukemia (CLL).

Acalabrutnib could play a role for patients who have an intolerance to ibrutinib (Imbruvica), says Barrientos. However, it would be off-label because there is no current FDA approval for acalabrutnib in CLL.

There is a phase III study that has completed accrual for patients with high-risk CLL. Investigators studied acalabrutinib versus ibrutinib, which has not been done before, explains Barrientos. It would be practice changing for a drug to have a better response rate and remission duration than ibrutinib. However, until the phase III trial data is released, it is not known if acalabrutinib is more beneficial to ibrutinib. It could have a better response rate, but if the remission duration is not as good, then it is not as beneficial. According to Barrientos, there is already 5-year long-term follow-up with ibrutinib, which will be hard to beat.

This randomized trial (NCT02477696; ACE-CL-006) is designed to evaluate the progression-free survival of acalabrutinib versus ibrutinib in patients with previously treated CLL. This trial is currently recruiting patients and will expect to see results in 2019.