MedPath

Acalabrutinib

Generic Name
Acalabrutinib
Brand Names
Calquence
Drug Type
Small Molecule
Chemical Formula
C26H23N7O2
CAS Number
1420477-60-6
Unique Ingredient Identifier
I42748ELQW
Background

To date, acalabrutinib has been used in trials studying the treatment of B-All, myelofibrosis, ovarian cancer, multiple myeloma, and Hodgkin lymphoma, among others.

As of October 31, 2017 the FDA approved Astra Zeneca's orally administered Calquence (acalabrutinib, capsules). This Bruton tyrosine kinase (BTK) inhibitor indicated for the treatment of chronic lymphocytic leukemia, small lymphocytic lymphoma, and in adult patients with Mantle cell lymphoma (MCL) who have already received at least one prior therapy. In August 2022, the FDA approved a new tablet formulation of Calquence, enabling the co-administration of this drug with proton pump inhibitors (PPIs). Unlike Calquence capsules, the co-administration of Calquence tablets and PPIs does not have an effect in the pharmacokinetics of acalabrutinib.

Also known as ACP-196, acalabrutinib is also considered a second generation BTK inhibitor because it was rationally designed to be more potent and selective than ibrutinib, theoretically expected to demonstrate fewer adverse effects owing to minimized bystander effects on targets other than BTK.

Nevertheless, acalabrutinib was approved under the FDA's accelerated approval pathway, which is based upon overall response rate and faciliates earlier approval of medicines that treat serious conditions or/and that fill an unmet medical need based on a surrogate endpoint. Continued approval for acalabrutinib's currently accepted indication may subsequently be contingent upon ongoing verification and description of clinical benefit in confimatory trials.

Furthermore, the FDA granted this medication Priority Review and Breakthrough Therapy designations. It also received Orphan Drug designation, which provides incentives to assist and encourage the development of drugs for rare diseases. At this time, more than 35 clinical trials across 40 countries with more than 2500 patients are underway or have been completed with regards to further research into better understanding and expanding the therapeutic uses of acalabrutinib .

Indication

Acalabrutinib is currently indicated for the treatment of adult patients with Mantle Cell Lymphoma (MCL) who have received at least one prior therapy. It has also been recently approved for chronic lymphocytic leukemia and small lymphocytic lymphoma.

Associated Conditions
Chronic Lymphocytic Leukemia, Mantle Cell Lymphoma (MCL), Small Lymphocytic Lymphoma

A Pilot "Window-3" Study of Acalabrutinib Plus Rituximab Followed by Brexucabtagene Autoleucel Therapy in Patients With Previously Untreated High-risk Mantle Cell Lymphoma

Early Phase 1
Recruiting
Conditions
Lymphoma
Mantle Cell Lymphoma
Interventions
First Posted Date
2022-08-10
Last Posted Date
2025-04-20
Lead Sponsor
M.D. Anderson Cancer Center
Target Recruit Count
20
Registration Number
NCT05495464
Locations
🇺🇸

M D Anderson Cancer Center, Houston, Texas, United States

Acalabrutinib, Venetoclax and Durvalumab for the Treatment of Richter Transformation From Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

Phase 2
Recruiting
Conditions
Chronic Lymphocytic Leukemia
Richter Syndrome
Small Lymphocytic Lymphoma
Interventions
Procedure: Biospecimen Collection
Procedure: Bone Marrow Aspiration
Procedure: Bone Marrow Biopsy
Procedure: Positron Emission Tomography (PET)
Procedure: Computed Tomography
First Posted Date
2022-05-24
Last Posted Date
2025-04-02
Lead Sponsor
Mayo Clinic
Target Recruit Count
33
Registration Number
NCT05388006
Locations
🇺🇸

Stanford Cancer Institute Palo Alto, Palo Alto, California, United States

🇺🇸

Washington University School of Medicine, Saint Louis, Missouri, United States

🇺🇸

Mayo Clinic in Rochester, Rochester, Minnesota, United States

Acalabrutinib in Combination With Venetoclax or Obinutuzumab for the Treatment of Treatment-naive Chronic Lymphocytic Leukemia

Phase 2
Recruiting
Conditions
Chronic Lymphocytic Leukemia
Small Lymphocytic Lymphoma
Interventions
First Posted Date
2022-04-20
Last Posted Date
2024-03-15
Lead Sponsor
Ohio State University Comprehensive Cancer Center
Target Recruit Count
52
Registration Number
NCT05336812
Locations
🇺🇸

Ohio State University Comprehensive Cancer Center, Columbus, Ohio, United States

Acalabrutinib Maintenance for the Treatment of Patients With Large B-cell Lymphoma

Phase 1
Recruiting
Conditions
Diffuse Large B-Cell Lymphoma
High-grade B-cell Lymphoma
Transformed Lymphoma
Secondary Central Nervous System Lymphoma
Interventions
First Posted Date
2022-02-25
Last Posted Date
2025-03-07
Lead Sponsor
Jonsson Comprehensive Cancer Center
Target Recruit Count
24
Registration Number
NCT05256641
Locations
🇺🇸

University of Oklahoma, Oklahoma City, Oklahoma, United States

🇺🇸

UCLA / Jonsson Comprehensive Cancer Center, Los Angeles, California, United States

🇺🇸

University of California Davis Comprehensive Cancer Center, Sacramento, California, United States

A Study of Tazemetostat in Combination With Various Treatments in Participants With Blood Cancer.

First Posted Date
2022-01-25
Last Posted Date
2023-08-15
Lead Sponsor
Epizyme, Inc.
Registration Number
NCT05205252
Locations
🇺🇸

Central Care Cancer Center, Bolivar, Missouri, United States

🇺🇸

California Cancer Associates For Research And Excellence, cCARE, Santa Fe, California, United States

🇺🇸

Astera Cancer Center, East Brunswick, New Jersey, United States

A Phase-3-trial of Acalabrutinib, Obinutuzumab & Venetoclax Compared to Obinutuzumab and Venetoclax in Previously Untreated Patients with High Risk CLL

Phase 3
Recruiting
Conditions
Chronic Lymphocytic Leukemia
Interventions
First Posted Date
2022-01-19
Last Posted Date
2024-12-30
Lead Sponsor
German CLL Study Group
Target Recruit Count
650
Registration Number
NCT05197192
Locations
🇩🇪

Staedtisches Klinikum Karlsruhe, Karlsruhe, Germany

🇩🇪

DRK Kliniken Berlin Köpenick, Berlin, Germany

🇩🇪

Helios Klinikum Bad Saarow, Bad Saarow, Germany

and more 27 locations

A Study to Evaluate the Effect of Pharmacokinetics (PK) of Acalabrutinib and Its Active Metabolite (ACP-5862) When Administered Alone and With Moderate CYP3A4 Inhibitors Fluconazole or Isavuconazole in Healthy Adult Participants

Phase 1
Completed
Conditions
Healthy Volunteers
Interventions
First Posted Date
2021-12-01
Last Posted Date
2021-12-01
Lead Sponsor
Acerta Pharma BV
Target Recruit Count
30
Registration Number
NCT05140096
Locations
🇺🇸

Celerion, Tempe, Arizona, United States

ACALA-R In Predominantly Demyelinating IgM Mediated Neuropathy

Phase 2
Recruiting
Conditions
Neuropathy;Peripheral
Waldenstrom Macroglobulinemia
IgM MGUS
Interventions
First Posted Date
2021-10-04
Last Posted Date
2025-04-24
Lead Sponsor
Shayna Sarosiek, MD
Target Recruit Count
33
Registration Number
NCT05065554
Locations
🇺🇸

Massachusetts General Hospital, Boston, Massachusetts, United States

🇺🇸

Dana Farber Cancer Institute, Boston, Massachusetts, United States

A Study of Acalabrutinib Plus Venetoclax Versus Venetoclax Plus Obinutuzumab in Previously Untreated Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

Phase 3
Active, not recruiting
Conditions
Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma
Interventions
First Posted Date
2021-09-27
Last Posted Date
2025-03-04
Lead Sponsor
AstraZeneca
Target Recruit Count
607
Registration Number
NCT05057494
Locations
🇪🇸

Research Site, Palma de Mallorca, Spain

Preventing Anaphylaxis With Acalabrutinib

Phase 2
Completed
Conditions
Food Allergy Peanut
Food Allergy
Interventions
First Posted Date
2021-09-09
Last Posted Date
2023-09-28
Lead Sponsor
Johns Hopkins University
Target Recruit Count
10
Registration Number
NCT05038904
Locations
🇺🇸

Johns Hopkins Bayview Medical Center, Baltimore, Maryland, United States

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