Dr. Byrd on the Rationale for the ELEVATE-RR Trial in CLL

John C. Byrd, MD, D. Warren Brown Chair of Leukemia Research, Distinguished University Professor of Medicine, Medicinal Chemistry and Veterinary Biosciences, senior advisor, Cancer Experimental Therapeutics, The Ohio State University Comprehensive Cancer Center–James, discusses the rationale for the phase 3 ELEVATE-RR trial (NCT02477696) in chronic lymphocytic leukemia (CLL).

The introduction of BTK inhibitors, such as ibrutinib (Imbruvica), have significantly improved the treatment landscape for patients with CLL, says Byrd. However, ibrutinib does not specifically target BTK and can induce off-target toxicities that can lead to serious adverse effects (AEs) and the need for treatment discontinuation, Byrd explains. As such, more specific, second-generation agents, such as acalabrutinib (Calquence), appear to result in less off-target AEs with similar efficacy, Byrd says.

The ELEVATE-RR trial evaluated the efficacy of acalabrutinib compared with ibrutinib in patients with previously treated CLL who required therapy. Findings from the trial, which were presented during the 2021 ASCO Annual Meeting, demonstrated noninferiority with acalabrutinib vs ibrutinib with a lower incidence of common AEs, grade 3 or higher AEs, serious AEs, and treatment discontinuations in this patient population, concludes Byrd.