Acalabrutinib: Managing Adverse Events and Improving Adherence in Patients With Mantle Cell Lymphoma

BACKGROUND: Acalabrutinib is a selective Bruton tyrosine kinase inhibitor approved for patients with relapsed or refractory mantle cell lymphoma, an aggressive B-cell malignancy. Treatment-related adverse events (AEs) can have a negative effect on treatment adherence. OBJECTIVES: This article aims to provide nurses with firsthand guidance so that they can better support patients with mantle cell lymphoma initiating acalabrutinib. METHODS: Safety data from the acalabrutinib ACE-LY-004 phase 2 trial in 124 patients with relapsed or refractory mantle cell lymphoma were reviewed, and strategies implemented at the University of Texas MD Anderson Cancer Center to manage trial AEs are described. FINDINGS: The most common AEs of any grade were headache and diarrhea, but no patients discontinued treatment because of them. When doses were missed or modified, patients were reeducated about the importance of adherence and how to manage AEs. Grade 1-2 AEs were managed with over-the-counter medication, if needed. These strategies allowed for the tracking of occurrences of nonadherence, providing the opportunity to advise and educate patients and to manage AEs more effectively.