Patients with acalabrutinib had lower discontinuation rates and a prolonged time to discontinuation compared to pts treated with ibrutinib.
Final data from a phase 1/2 clinical trial with six years of follow-up show that first-line acalabrutinib produces high response rates and rapid, durable responses in patients with CLL
I am grateful to Nathan Vardi for illuminating this incredible story’s corners, and I highly recommend his book.
Our own Dr. Brian Koffman interviewed Dr. Matthew Davids, Associate Director of the Center for Chronic Lymphocytic Leukemia (CLL) at Dana-Farber Cancer Institute. They discussed the results of a new study looking at whether combining the anti-CD20 monoclonal antibody obinutuzumab with the BTK inhibitor acalabrutinib provided any additional survival benefit.
In this interview, our own Dr. Brian Koffman interviewed Dr. John Seymour, Director of the Department of Hematology at Peter MacCallum Cancer Centre & Royal Melbourne Hospital in Melbourne, Australia. They discussed the latest updates to the safety data from the ELEVATE R/R study, which was the first clinical trial to compare acalabrutinib and ibrutinib head-to-head.
In this ongoing trial, the triple combination therapy with acalabrutinib, venetoclax, and obinutuzumab is highly active and has thus far produced durable remissions as a frontline treatment in patients with TP53-aberrant chronic lymphocytic leukemia (CLL), which was generally well tolerated with a low 2.9% incidence of atrial fibrillation with none of the more serious abnormal ventricular heart irregularities seen.
The combination of obinutuzumab (Gazyva), acalabrutinib (Calquence), and venetoclax (Venclexta) failed to meet the pre-specified rate of undetectable measurable or minimal residual disease (uMRD) following optimal debulking with bendamustine in patients with relapsed/refractory chronic lymphocytic leukemia (CLL).
In summary, the results of MAJIC will help to inform the selection of time-limited doublet therapy approaches for patients with CLL / SLL and help define the duration of venetoclax in combination with either acalabrutinib or obinutuzumab.
Acalabrutinib plus high-frequency, low-dose subcutaneous rituximab is tolerable and effective. In addition, because it can be administered at home, it is more convenient and can decrease patient infection risk during pandemics. However, while it does control disease, it does not lead to undetectable measurable residual disease (uMRD).
