Common brand names

• Calquence

How it is administered

Acalabrutinib is taken by mouth as a tablet or capsule. The recommended dose is 100 mg orally approximately every 12 hours. It can be taken with or without food. Tablets or capsules should be swallowed whole with water and should not be chewed, crushed, dissolved, opened, or cut. If a dose is missed by more than 3 hours, skip the missed dose and take the next dose at the usual time. Do not take extra doses to make up for a missed dose.

How it works

Acalabrutinib is a small-molecule inhibitor of Bruton tyrosine kinase (BTK), a protein that plays a key role in the survival and growth of certain cancerous B cells. By binding to BTK, acalabrutinib blocks its activity, which disrupts signals that help cancer cells grow, divide, and move around the body. This action helps to slow down or stop the growth of cancer cells in diseases like mantle cell lymphoma (MCL) and other B-cell malignancies.

In clinical studies, acalabrutinib has shown to inhibit the activation of downstream signaling proteins and reduce the proliferation of malignant B cells. This targeted approach can help control the progression of blood cancers, especially in patients who have not responded to other treatments.

Who should take it

Acalabrutinib is indicated for adults with mantle cell lymphoma (MCL) in two main situations:

• In combination with bendamustine and rituximab for patients with previously untreated MCL who are not eligible for autologous stem cell transplantation.
• As a single agent for patients with MCL who have received at least one prior therapy.

It is also approved for adults with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). Your healthcare provider will determine if acalabrutinib is appropriate for you based on your diagnosis, previous treatments, and overall health.

Who should not take it

There are no absolute contraindications listed for acalabrutinib. However, caution is advised in certain situations:

• Patients with severe hepatic (liver) impairment should not take acalabrutinib.
• Women who are pregnant or may become pregnant should avoid this medication, as it may cause harm to the fetus.
• Breastfeeding women should not use acalabrutinib and should avoid breastfeeding for at least 2 weeks after the last dose.

Patients should inform their healthcare provider about all other medications and health conditions before starting acalabrutinib, especially if they have a history of infections, bleeding disorders, heart rhythm problems, or other cancers.

Commonly used with

For previously untreated mantle cell lymphoma, acalabrutinib is commonly used in combination with bendamustine and rituximab. In other blood cancers, it may be used with obinutuzumab. Your doctor may also prescribe other supportive medications to help manage side effects or prevent infections.

Commonly tested with

Acalabrutinib has been studied in combination with bendamustine and rituximab for mantle cell lymphoma, and with obinutuzumab for chronic lymphocytic leukemia and small lymphocytic lymphoma. It has also been compared to other regimens such as idelalisib plus rituximab or bendamustine plus rituximab in clinical trials.