Pooled analysis of safety data from clinical trials evaluating acalabrutinib monotherapy in mature B-cell malignancies

Richard R. Furman, John C. Byrd, Roger G. Owen, Susan M. O’Brien, Jennifer R. Brown, Peter Hillmen, Deborah M. Stephens, Nataliya Chernyukhin, Tamara Lezhava, Ahmed M. Hamdy, Raquel Izumi, Priti Patel, Marshall Baek, Beth Christian, Martin J.S. Dyer, Matthew J. Streetly, Clare Sun, Simon Rule, Michael Wang, Paolo GhiaWojciech Jurczak, John M. Pagel, Jeff P. Sharman

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

Bruton tyrosine kinase (BTK) inhibition is an effective therapy for many B-cell malignancies. Acalabrutinib is a next-generation, potent, highly selective, covalent BTK inhibitor. To characterize acalabrutinib tolerability, we pooled safety data from 1040 patients with mature B-cell malignancies treated with acalabrutinib monotherapy in nine clinical studies (treatment-naïve: n = 366 [35%], relapsed/refractory: n = 674 [65%]; median [range] age: 67 [32–90] years; median [range] prior treatments: 1 [0–13]; median [range] duration of exposure: 24.6 [0.0–58.5] months). The most common adverse events (AEs) were headache (38%), diarrhea (37%), upper respiratory tract infection (22%), contusion (22%), nausea (22%), fatigue (21%), and cough (21%). Serious AEs (SAEs) occurred in 39% of patients; pneumonia (6%) was the only SAE that occurred in ≥2%. Deaths due to AEs occurred in 52 patients (5%); pneumonia (n = 8) was the only fatal AE to occur in ≥3 patients. AEs led to treatment discontinuation in 9%. Rates for the AEs of interest (all grades) included infections (67%), hemorrhages (46%), neutropenia (16%), anemia (14%), second primary malignancies (12%), thrombocytopenia (9%), hypertension (8%), and atrial fibrillation (4%). This pooled analysis confirmed acalabrutinib’s tolerability and identified no newly emerging late toxicities, supporting acalabrutinib as a long-term treatment for patients with mature B-cell malignancies.

Original languageEnglish (US)
Pages (from-to)3201-3211
Number of pages11
JournalLeukemia
Volume35
Issue number11
DOIs
StatePublished - Nov 2021

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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