Dr. Richard Furman has a long and broad experience with the novel agents that are revolutionizing the treatment of chronic lymphocytic leukemia (CLL). I had the opportunity to sit down with him at the 2016 American Society of Hematology annual meeting in San Diego to talk about acalabrutinib and the latest data for its use in battling CLL.
Take away Points:
- Blocking BTK is proving to be the best way to control CLL.
- Long-term use of medications that block BTK is necessary.
- Medications with fewer side effects may make it easier to stay on therapy.
Acalabrutinib, formerly known as ACP-196, is a trial drug that blocks the same enzyme (BTK or Bruton’s Tyrosine Kinase) as ibrutinib does. It also binds at the exact same site on the CLL cells, but it may block fewer other enzymes. This increased selectivity for acalabrutinib might mean that some of the side effects associated with ibrutinib, such as rash and diarrhea may occur less frequently with this new drug. Whether there is less atrial fibrillation and bruising is yet to be determined. In the short term, with more limited data, it seems to be equally effective as the very effective ibrutinib.
For patients who need to discontinue ibrutinib because of disease progression, there is little reason to hope that acalabrutinib would be a good option. However, for those who stop the drug due to its side effects, there now is both bench science and early clinical evidence that acalabrutinib might be an excellent alternative.
Drugs only work if we take them and if acalabrutinib is easier to take and to tolerate, then that is good news.
Its approval could provide another powerful non-chemo option for all of us with CLL.
Here is a link to one of the abstracts from ASH 2016 that we discussed: Acalabrutinib Monotherapy in Patients with Ibrutinib Intolerance: Results from the Phase 1/2 ACE-CL-001 Clinical Study.
Dr. Furman is a great help to us at the CLL Society and is an active member of our medical advisory board.
Here is our interview:
Brian Koffman, MD