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

Acalabrutinib and Obinutuzumab for the Treatment of Previously Untreated Follicular Lymphoma or Other Indolent Non-Hodgkin Lymphomas

Phase 2
Recruiting
Conditions
Grade 2 Follicular Lymphoma
Marginal Zone Lymphoma
Grade 1 Follicular Lymphoma
Grade 3a Follicular Lymphoma
Indolent Non-Hodgkin Lymphoma
Lymphoplasmacytic Lymphoma
Lymphoproliferative Disorder
Mantle Cell Lymphoma
Interventions
Other: Quality-of-Life Assessment
Other: Questionnaire Administration
First Posted Date
2021-05-12
Last Posted Date
2025-03-27
Lead Sponsor
Emory University
Target Recruit Count
49
Registration Number
NCT04883437
Locations
🇺🇸

Emory University Hospital/Winship Cancer Institute, Atlanta, Georgia, United States

Efficacy of Acalabrutinib in Very Old or Frail Patients with Treatment-naïve or Relapsed/Refractory CLL

Phase 2
Active, not recruiting
Conditions
Chronic Lymphoid Leukemia
Interventions
First Posted Date
2021-05-12
Last Posted Date
2024-12-30
Lead Sponsor
German CLL Study Group
Target Recruit Count
53
Registration Number
NCT04883749
Locations
🇩🇪

Universitaetsklinikum Essen, Essen, Germany

🇩🇪

Onkologische Kooperation Harz, Goslar, Germany

🇩🇪

OncoResearch Lerchenfeld, Hamburg, Germany

and more 16 locations

A Study to Evaluate the Effect of an Acidic Formulation of Acalabrutinib (ACP-196), Acidic Beverage, or Grapefruit Juice on the Pharmacokinetics (PK) of ACP-196 Alone and Coadministered With Omeprazole

Phase 1
Completed
Conditions
Healthy Volunteers
Interventions
First Posted Date
2021-05-07
Last Posted Date
2021-05-07
Lead Sponsor
Acerta Pharma BV
Target Recruit Count
36
Registration Number
NCT04876807
Locations
🇺🇸

Laura Sterling, MD, MPH, Lincoln, Nebraska, United States

A Study to Evaluate the Effect of Hepatic Insufficiency on the Pharmacokinetics (PK) of ACP-196

Phase 1
Completed
Conditions
Hepatic Insufficiency
Interventions
First Posted Date
2021-04-30
Last Posted Date
2021-04-30
Lead Sponsor
Acerta Pharma BV
Target Recruit Count
18
Registration Number
NCT04867941
Locations
🇺🇸

Research Site, Knoxville, Tennessee, United States

A Study to Evaluate the Effect of ACP-196 on the Heart Rate-corrected QT Interval in Healthy Adult Participants

Phase 1
Completed
Conditions
Healthy Volunteers
Interventions
First Posted Date
2021-04-30
Last Posted Date
2021-04-30
Lead Sponsor
Acerta Pharma BV
Target Recruit Count
48
Registration Number
NCT04867980
Locations
🇺🇸

Celerion, Tempe, Arizona, United States

Avo In R/R And Previously Untreated MCL

Phase 1
Recruiting
Conditions
Mantle Cell Lymphoma
Refractory Lymphoma
Interventions
First Posted Date
2021-04-22
Last Posted Date
2025-01-29
Lead Sponsor
Austin I Kim
Target Recruit Count
53
Registration Number
NCT04855695
Locations
🇺🇸

University of Chicago Medical Center, Chicago, Illinois, United States

🇺🇸

Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States

🇺🇸

Dana-Farber Cancer Institute, Boston, Massachusetts, United States

Acalabrutinib and Duvelisib for the Treatment of Relapsed/Refractory Indolent Non-Hodgkin Lymphoma

Phase 1
Withdrawn
Conditions
Refractory Marginal Zone Lymphoma
Refractory Nodal Marginal Zone Lymphoma
Refractory Splenic Marginal Zone Lymphoma
Recurrent Follicular Lymphoma
Recurrent Marginal Zone Lymphoma
Recurrent Nodal Marginal Zone Lymphoma
Recurrent Splenic Marginal Zone Lymphoma
Refractory Follicular Lymphoma
Refractory Indolent Non-Hodgkin Lymphoma
Interventions
First Posted Date
2021-04-08
Last Posted Date
2022-06-07
Lead Sponsor
Narendranath Epperla
Registration Number
NCT04836832

Acalabrutinib, Umbralisib, and Ublituximab for the Treatment of Previously Untreated Mantle Cell Lymphoma

Phase 2
Active, not recruiting
Conditions
Mantle Cell Lymphoma
Interventions
First Posted Date
2021-03-05
Last Posted Date
2024-12-02
Lead Sponsor
City of Hope Medical Center
Target Recruit Count
12
Registration Number
NCT04783415
Locations
🇺🇸

City of Hope Medical Center, Duarte, California, United States

Study to Assess the Bioequivalence of Acalabrutinib Tablet and Acalabrutinib Capsule

Phase 1
Completed
Conditions
Bioequivalence
First Posted Date
2021-02-24
Last Posted Date
2022-07-08
Lead Sponsor
AstraZeneca
Target Recruit Count
66
Registration Number
NCT04768985
Locations
🇺🇸

Research Site, Salt Lake City, Utah, United States

Acalabrutinib and Rituximab for the Treatment of Previously Untreated Mantle Cell Lymphoma

Phase 2
Active, not recruiting
Conditions
Mantle Cell Lymphoma
Interventions
First Posted Date
2021-02-21
Last Posted Date
2025-05-15
Lead Sponsor
M.D. Anderson Cancer Center
Target Recruit Count
53
Registration Number
NCT04765111
Locations
🇺🇸

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

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