Julie Vose, MD, MBA, Discussed Toxicities Associated With Acalabrutinib or Ibrutinib for Chronic Lymphocytic Leukemia

At the 2021 American Society of Clinical Oncology Annual Meeting (ASCO), CancerNetwork® spoke with Julie Vose, MD, MBA, about the phase 3 ELEVATE CLL R/R trial (NCT02477696) concerning acalabrutinib (Calquence) versus ibrutinib (Imbruvica) for the treatment of patients with relapsed or refractory high-risk chronic lymphocytic leukemia (CLL). Vose focused on the toxicities associated with the treatments with the second-generation Brurton tyrosine kinase inhibitor potentially showing fewer toxic effects.

The study was a randomized, open-label, multicenter trial with the primary end point of progression-free survival and the secondary end points including the incidence of treatment-emergent infections of grade 3 or greater and overall survival.

Transcript:

One [abstract from ASCO 2021] that was very interesting to me was a trial that was in CLL, chronic lymphocytic leukemia, where patients were randomized to acalabrutinib versus ibrutinib for [the treatment of] CLL. This trial was a noninferiority trial so that the outcomes as far as responses were not that clinically significantly different [between arms]. What was different was the toxicities. We had always felt that possibly the second-generation Bruton tyrosine kinase inhibitors would be less toxic. This was the first trial that demonstrated that in a randomized trial, where the acalabrutinib, which is a second-generation [agent, caused] less atrial fibrillation and less hypertension. It did have a little bit higher [toxicity] in some categories, such as headach. I think it showed some of the changes that we felt were always there [we have now seen] demonstrated in a prospective randomized trial.

References

Byrd J, Hillmen P, Ghia P, et al. First results of a head-to-head trial of acalabrutinib versus ibrutinib in previously treated chronic lymphocytic leukemia. J Clin Oncol. 2021;39(suppl 15):7500. doi: 10.1200/JCO.2021.39.15_suppl.7500