Acalabrutinib is a second-generation Bruton’s Tyrosine Kinase (BTK) inhibitor that is marketed under the Calquence brand. This targeted therapy is mostly used to treat specific blood malignancies and is taken orally. BTK, a protein that aids in the survival and growth of cancer cells, is blocked by acalabrutinib. The medication slows the evolution of illnesses including mantle cell lymphoma (MCL) and chronic lymphocytic leukemia (CLL) by blocking BTK, which stops the growth of cancerous B-cells.

Calquence capsules come in bottles or blister packs and contain 100 mg of acalabrutinib each. It is often taken until the disease progresses or the toxicity becomes intolerable. It is prescribed as part of long-term cancer treatment.

Uses

Small lymphocytic lymphoma (SLL) and chronic lymphocytic leukemia (CLL) are used either alone or in conjunction with other therapies.

Mantle Cell Lymphoma (MCL): Recommended for adults with at least one previous treatment.

The medication is being studied for autoimmune disorders and other hematologic cancers.

Dosage and Administration

For the majority of individuals, the usual dosage is 100 mg (one capsule) given orally twice a day, every 12 hours.

Taking it with or without food is possible.

It is recommended to drink the entire capsule with water. The capsule should not be opened, chewed, crushed, or dissolved.

Missed Dose:

Take the dose right away if you miss it by less than three hours.

Take the next dose at the appointed time and skip the previous one if it has been more than three hours.

Never take additional doses to make up for a missing one.

Dose Modifications

In the event of significant adverse effects or medication interactions with CYP3A inhibitors or inducers, dosage modifications might be necessary.

Dosage adjustments or extra monitoring may be necessary for patients with liver impairment.

Side Effects of Acalabrutinib

Like all medications, Calquence may cause side effects. Some common and serious side effects include:

Common Side Effects (Mild to Moderate):
Headache
Fatigue
Diarrhea
Nausea
Bruising
Muscle and joint pain
Cough

Serious Side Effects (Require Immediate Medical Attention):

Bacterial, viral, and fungal infections are more likely to occur.

Bleeding (Hemorrhage): Blood in the stool or urine, easy bruising, or unusual bleeding.

An irregular heartbeat, dyspnea, or chest pain are symptoms of atrial fibrillation (heart problems).

Secondary Cancers: A slightly higher chance of getting skin cancer and other cancers.
Increased liver enzymes that cause jaundice or other liver-related problems are known as liver toxicity.

Anemia, thrombocytopenia, or neutropenia are examples of cytopenias (low blood counts).
Patients should notify their healthcare practitioner right away if they see any indications of severe bleeding, infections, or allergic reactions.

Drug Interactions

CYP3A Inhibitors (such as ritonavir, clarithromycin, and ketoconazole): May raise acalabrutinib levels, increasing toxicity.

Acalabrutinib’s effectiveness may be diminished by CYP3A Inducers, such as rifampin, carbamazepine, and St. John’s Wort, which may lower its levels.

Using anticoagulants or antiplatelets simultaneously increases the risk of bleeding.

Omeprazole and other proton pump inhibitors (PPIs) may decrease the absorption of drugs.

Before beginning acalabrutinib, always let your doctor know about any drugs, herbal items, or supplements you are taking.

Storage Instructions

Keep it between 20°C and 25°C (68°F and 77°F) at room temperature.

Keep the capsules well sealed in their original packaging.

Keep out of direct sunlight and moisture.

Conclusion

Acalabrutinib, also known as Calquence, is a very successful BTK inhibitor that is used to treat MCL and CLL. Although it is usually well tolerated, patients should be informed about the risks of bleeding, possible side effects, and drug interactions. For treatment to be effective, dose, storage, and following doctor’s instructions are essential.

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Q. How long does acalabrutinib treatment last?

Security. Overall, the median duration of treatment was 53 months (range: 1-59) (56 months for 200 mg once daily [n = 37] and 50 months for 100 mg twice daily [n = 62]). Acalabrutinib was given for a median of 52 months (range: 0.2-60). 85 patients (86%) were still receiving treatment at the time of this study.

Q. What is the acalabrutinib success rate?

Three patients (5%) experienced total remission, and the overall response rate to acalabrutinib was 73%. The 24-month estimates for overall and progression-free survival were 81% and 72%, respectively, and were not met after a median follow-up of 35 months.