Promising results for acalabrutinib in chronic lymphocytic leukaemia (CLL)

Acalabrutinib shows potential as a chemotherapy-free treatment option for people with CLL who have not been treated before.

Text that says Results

Acalabrutinib is a type of targeted drug called a cell signal blocker. It blocks a protein called ‘BTK’ on B cells. BTK is a part of a pathway that helps B cells to stay alive and divide. Blocking BTK can make B cells die or prevent them dividing. It is a capsule that you take by mouth every day unless your lymphoma gets worse or you develop troublesome side effects.

Results of a study published recently in the Lancet recently have shown that it could be an effective new treatment for chronic lymphocytic leukaemia (CLL).

In the ELEVATE TN trial, 535 people with CLL who had not been treated before were given either:

  • acalabrutinib on its own
  • acalabrutinib plus six cycles of obinutuzumab
  • six cycles of chlorambucil plus obinutuzumab

The study found that after around 28 months of follow-up, people who were treated with acalabrutinib, either on its own or with obinutuzumab, had longer periods before their lymphoma got worse than people who were treated with chlorambucil plus obinutuzumab. In people who were treated with the combination of acalabrutinib and obinutuzumab, there was a 90% lower risk of lymphoma progression or death compared to people who were treated with chlorambucil plus obinutuzumab.

The results were analysed according to whether or not people with CLL had a genetic mutation called 17p deletion. People treated with acalabrutinib, on its own or with obinutuzumab, had better outcomes than people treated with chlorambucil and obinutuzumab regardless of their mutation status.

The most common side effect in all treatment groups was a low neutrophil count (neutropenia). People treated with acalabrutinib were more likely to experience bleeding than people treated with chlormabucil plus obinutuzumab, but this was generally mild and manageable.

The study authors conclude that acalabrutinib, with or without obinutuzumab, represents a potential new, chemotherapy-free treatment option for people with CLL who have not been treated before.

17 June 2020