ACALABRUTINIB IN THE TREATMENT OF CHRONIC LYMPHOCYTIC LEUKEMIA

Authors

DOI:

https://doi.org/10.47820/recima21.v4i6.3311

Keywords:

Chronic lymphocytic leukemia

Abstract

Introduction: Chronic lymphocytic leukemia is the most common adult leukemia. It is characterized by clonal expansion of mature CD5+ B cells into blood, bone marrow, and lymphoid tissues. Objectives: To evaluate the efficacy and adverse events of the use of acalabrutinib in the treatment of chronic lymphocytic leukemia. Materials and methods: This is an integrative review, in which the guiding question was “Is acalabrutinib effective in the treatment of chronic lymphocytic leukemia?”. The search for articles was carried out in the main databases (PubMed and Scielo) using the terms “acalabrutinib” and “chronic lymphocytic leukemia”, combined using Boolean operators. Results and Discussion: Compared to ibrutinib, acalabrutinib is highly selective and characterized by a lack of inhibition towards other kinases. Overall survival comparisons favored acalabrutinib alone and in combination with obinutuzumab over all comparators. Acalabrutinib monotherapy was also associated with statistically improved progression-free survival over obinutuzumab-chlorambucil. Conclusion: Acalabrutinib is an effective and safe treatment of chronic lymphocytic leukemia. Acalabrutinib plus obinutuzumab or acalabrutinib monotherapy were associated with improved efficacy over standard immunochemotherapy.

Downloads

Download data is not yet available.

Author Biographies

Carollayne Mendonça Rocha

Universidade José do Rosário Vellano - UNIFENAS.

Breno Camargo Ribeiro

Universidade Professor Edson Antônio Velano - UNIFENAS.

Gustavo Dourado Franco

Universidade Professor Edson Antônio Velano - UNIFENAS.

Hugo Abboud

Universidade Professor Edson Antônio Velano - UNIFENAS.

Isabella Sales dos Santos

Universidade Professor Edson Antônio Velano - UNIFENAS.

João Pedro Guedes Pinto

Universidade Professor Edson Antônio Velano - UNIFENAS.

Julia de Oliveira Lima

Universidade Professor Edson Antônio Velano - UNIFENAS.

Murilo Monroe Mota

Universidade Professor Edson Antônio Velano - UNIFENAS.

Vinicius do Prado

Universidade Professor Edson Antônio Velano - UNIFENAS.

Eric Azara de Oliveira

Universidade Professor Edson Antônio Velano - UNIFENAS.

References

Kikushige Y. Pathogenesis of chronic lymphocytic leukemia and the development of novel therapeutic strategies. J Clin Exp Hematop. 2020 Dec 15;60(4):146-158. doi: 10.3960/jslrt.20036. Epub 2020 Nov 4. PMID: 33148933; PMCID: PMC7810248.

Yoshino T, Tanaka T, Sato Y. Differential diagnosis of chronic lymphocytic leukemia/small lymphocytic lymphoma and other indolent lymphomas, including mantle cell lymphoma. J Clin Exp Hematop. 2020 Dec 15;60(4):124-129. doi: 10.3960/jslrt.19041. Epub 2020 Apr 3. PMID: 32249238; PMCID: PMC7810253.

Byrd JC, Woyach JA, Furman RR, Martin P, O'Brien S, Brown JR, Stephens DM, Barrientos JC, Devereux S, Hillmen P, Pagel JM, Hamdy A, Izumi R, Patel P, Wang MH, Jain N, Wierda WG. Acalabrutinib in treatment-naive chronic lymphocytic leukemia. Blood. 2021 Jun 17;137(24):3327-3338. doi: 10.1182/blood.2020009617. PMID: 33786588; PMCID: PMC8670015.

International CLL-IPI working group . An international prognostic index for patients with chronic lymphocytic leukaemia (CLL-IPI): a meta-analysis of individual patient data. Lancet Oncol. 2016;17(6):779-790

Michallet AS, Aktan M, Hiddemann W, et al. Rituximab plus bendamustine or chlorambucil for chronic lymphocytic leukemia: primary analysis of the randomized, open-label MABLE study. Haematologica. 2018;103(4):698-706.

O’Brien S, Furman RR, Coutre S, et al. Single-agent ibrutinib in treatment-naïve and relapsed/refractory chronic lymphocytic leukemia: a 5-year experience. Blood. 2018;131(17):1910-1919.

Woyach JA, Ruppert AS, Heerema NA, et al. Ibrutinib regimens versus chemoimmunotherapy in older patients with untreated CLL. N Engl J Med. 2018;379(26):2517-2528.

Awan FT, Schuh A, Brown JR, Furman RR, Pagel JM, Hillmen P, Stephens DM, Woyach J, Bibikova E, Charuworn P, Frigault MM, Hamdy A, Izumi R, Linghu B, Patel P, Wang MH, Byrd JC. Acalabrutinib monotherapy in patients with chronic lymphocytic leukemia who are intolerant to ibrutinib. Blood Adv. 2019 May 14;3(9):1553-1562. doi: 10.1182/bloodadvances.2018030007. PMID: 31088809; PMCID: PMC6517672.

Byrd JC, Hillmen P, Ghia P, Kater AP, Chanan-Khan A, Furman RR, O'Brien S, Yenerel MN, Illés A, Kay N, Garcia-Marco JA, Mato A, Pinilla-Ibarz J, Seymour JF, Lepretre S, Stilgenbauer S, Robak T, Rothbaum W, Izumi R, Hamdy A, Patel P, Higgins K, Sohoni S, Jurczak W. Acalabrutinib Versus Ibrutinib in Previously Treated Chronic Lymphocytic Leukemia: Results of the First Randomized Phase III Trial. J Clin Oncol. 2021 Nov 1;39(31):3441-3452. doi: 10.1200/JCO.21.01210. Epub 2021 Jul 26. PMID: 34310172; PMCID: PMC8547923.

Ghia P, Pluta A, Wach M, et al. ASCEND: Phase III, randomized trial of acalabrutinib versus idelalisib plus rituximab or bendamustine plus rituximab in relapsed or refractory chronic lymphocytic leukemia. J Clin Oncol. 2020;38(25):2849-2861.

Sharman JPE, Egyed M, Jurczak W, et al. Acalabrutinib with or without obinutuzumab versus chlorambucil and obinutuzmab for treatment-naive chronic lymphocytic leukaemia (ELEVATE TN): a randomised, controlled, phase 3 trial. Lancet. 2020;395(10232):1278-1291.

SOUZA, Marcela Tavares de; SILVA, Michelly Dias da; CARVALHO, Rachel de. Revisão integrativa: o que é e como fazer. Einstein (São Paulo), v. 8, p. 102-106, 2010.

Zhang J, Lu X, Li J, Miao Y. Combining BTK inhibitors with BCL2 inhibitors for treating chronic lymphocytic leukemia and mantle cell lymphoma. Biomark Res. 2022 Apr 4;10(1):17. doi: 10.1186/s40364-022-00357-5. PMID: 35379357; PMCID: PMC8981798.

Vitale C, Gibbons JL, Ferrajoli A. Targeted Treatment of Chronic Lymphocytic Leukemia: Clinical Utility of Acalabrutinib. Onco Targets Ther. 2021 Dec 29;14:5507-5519. doi: 10.2147/OTT.S303060. PMID: 35002256; PMCID: PMC8721287.

Davids MS, Waweru C, Le Nouveau P, Padhiar A, Singh G, Abhyankar S, Leblond V. Comparative Efficacy of Acalabrutinib in Frontline Treatment of Chronic Lymphocytic Leukemia: A Systematic Review and Network Meta-analysis. Clin Ther. 2020 Oct;42(10):1955-1974.e15. doi: 10.1016/j.clinthera.2020.08.017. Epub 2020 Oct 6. PMID: 33032842.

Sun C, Nierman P, Kendall EK, Cheung J, Gulrajani M, Herman SEM, Pleyer C, Ahn IE, Stetler-Stevenson M, Yuan CM, Maric I, Gaglione EM, Harris HM, Pittaluga S, Wang MH, Patel P, Farooqui MZH, Izumi R, Hamdy A, Covey T, Wiestner A. Clinical and biological implications of target occupancy in CLL treated with the BTK inhibitor acalabrutinib. Blood. 2020 Jul 2;136(1):93-105. doi: 10.1182/blood.2019003715. PMID: 32202637; PMCID: PMC7332900.

Alsadhan A, Cheung J, Gulrajani M, Gaglione EM, Nierman P, Hamdy A, Izumi R, Bibikova E, Patel P, Sun C, Covey T, Herman SEM, Wiestner A. Pharmacodynamic Analysis of BTK Inhibition in Patients with Chronic Lymphocytic Leukemia Treated with Acalabrutinib. Clin Cancer Res. 2020 Jun 15;26(12):2800-2809. doi: 10.1158/1078-0432.CCR-19-3505. Epub 2020 Feb 13. PMID: 32054731; PMCID: PMC8301526.

Byrd JC, Hillmen P, Ghia P, Kater AP, Chanan-Khan A, Furman RR, O'Brien S, Yenerel MN, Illés A, Kay N, Garcia-Marco JA, Mato A, Pinilla-Ibarz J, Seymour JF, Lepretre S, Stilgenbauer S, Robak T, Rothbaum W, Izumi R, Hamdy A, Patel P, Higgins K, Sohoni S, Jurczak W. Acalabrutinib Versus Ibrutinib in Previously Treated Chronic Lymphocytic Leukemia: Results of the First Randomized Phase III Trial. J Clin Oncol. 2021 Nov 1;39(31):3441-3452. doi: 10.1200/JCO.21.01210. Epub 2021 Jul 26. PMID: 34310172; PMCID: PMC8547923.

Vitale C, Gibbons JL, Ferrajoli A. Targeted Treatment of Chronic Lymphocytic Leukemia: Clinical Utility of Acalabrutinib. Onco Targets Ther. 2021 Dec 29;14:5507-5519. doi: 10.2147/OTT.S303060. PMID: 35002256; PMCID: PMC8721287.

Published

09/06/2023

How to Cite

Mendonça Rocha, C., Camargo Ribeiro, B., Dourado Franco, G., Abboud, H., Sales dos Santos, I., Guedes Pinto, J. P., … Azara de Oliveira, E. (2023). ACALABRUTINIB IN THE TREATMENT OF CHRONIC LYMPHOCYTIC LEUKEMIA. RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218, 4(6), e463311. https://doi.org/10.47820/recima21.v4i6.3311