Use of acalabrutinib in patients with mantle cell lymphoma

ABSTRACT

Introduction: Acalabrutinib, a selective Bruton tyrosine kinase (BTK) inhibitor, was granted accelerated approval by the FDA on 31 October 2017 for the treatment of patients with mantle cell lymphoma (MCL) who have received at least one prior therapy.

Areas covered: This narrative review provides an overview of acalabrutinib, its use in clinical practice and potential future developments.

Expert commentary: BTK inhibitors have demonstrated efficacy in patients with relapsed or refractory MCL. To prepare patients for therapy, all preexisting infections should be diagnosed and treated, and infection prophylaxis undertaken. Serious adverse reactions are rare with acalabrutinib; however, patients should be made aware of common adverse events such as headaches, which usually resolve within one month without medical treatment. Interaction with other drugs appears to be less of an issue with acalabrutinib than with ibrutinib; however, patients receiving acalabrutinib therapy must be advised not to take any additional medications without first consulting with their treating physician. A key unmet medical need is treatment options for patients in whom BTK inhibitors are discontinued, because of either intolerance or refractory disease. Patients not tolerating ibrutinib could be switched to acalabrutinib, which has improved selectivity and increased tolerability. First-line treatment with acalabrutinib is being investigated.

KEYWORDS:

• Acalabrutinib
• adverse events
• B-cell malignancies
• Bruton tyrosine kinase inhibitor
• efficacy
• mantle cell lymphoma

Declaration of interest

FT Awan has served in an advisory role for Pharmacyclics, Gilead, AbbVie and has received research funding from Pharmacyclics and Innate Pharma. W Jurczak has received grants from Acerta, Gilead, Janssen, Merck, Pfizer, Sandoz, Takeda, and TG Therapeutics. Anja Becher, PhD, of Oxford PharmaGenesis, Oxford, UK, provided medical writing support, which was in accordance with Good Publication Practice (GPP3) guidelines and funded by AstraZeneca (Wilmington, DE, USA). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work was supported by AstraZeneca (Wilmington, DE, USA).