Common brand names

• Calquence

How it is administered

Acalabrutinib is taken by mouth as a tablet or capsule. The usual recommended dose is 100 mg approximately every 12 hours (twice daily), swallowed whole with water. It can be taken with or without food. Patients should not chew, crush, dissolve, or cut the tablets or open, break, or chew the capsules. If a dose is missed by more than 3 hours, it should be skipped, and the next dose taken at the usual time.

How it works

Acalabrutinib is a type of targeted therapy known as a Bruton tyrosine kinase (BTK) inhibitor. BTK is an important protein in B cells, a type of white blood cell that can become cancerous in blood cancers like Waldenström's Macroglobulinemia, mantle cell lymphoma, and chronic lymphocytic leukemia.

Acalabrutinib and its active metabolite work by forming a bond with BTK, blocking its activity. This prevents the signals that tell B cells to grow, move, and survive. By inhibiting BTK, acalabrutinib helps slow down or stop the growth of abnormal B cells, reducing the progression of the cancer. This targeted action helps to specifically affect cancerous B cells while having less impact on other cells in the body.

Who should take it

Acalabrutinib is indicated for adults with certain types of blood cancers, including mantle cell lymphoma (MCL), chronic lymphocytic leukemia (CLL), and small lymphocytic lymphoma (SLL). It can be used alone or in combination with other medications like bendamustine and rituximab for previously untreated MCL, or with obinutuzumab for previously untreated CLL/SLL.

While there is no specific FDA indication for Waldenström's Macroglobulinemia, acalabrutinib's mechanism of action and use in related B-cell malignancies may make it relevant in some cases, as determined by your doctor. Patients should discuss with their healthcare provider if acalabrutinib is appropriate for their specific diagnosis and treatment plan.

Who should not take it

There are no absolute contraindications listed for acalabrutinib, but it should be avoided in patients with severe hepatic (liver) impairment. Caution is also advised in patients with a history of serious infections, bleeding disorders, or heart rhythm problems, as these conditions may be worsened by acalabrutinib.

Women who are pregnant or may become pregnant should not take acalabrutinib, as it can cause harm to an unborn baby. Breastfeeding is not recommended during treatment and for at least 2 weeks after the last dose. Always inform your healthcare provider about all your medical conditions and medications before starting acalabrutinib.

Commonly used with

Acalabrutinib is often used in combination with other cancer medications, depending on the type of blood cancer being treated. For previously untreated mantle cell lymphoma, it is commonly combined with bendamustine and rituximab. For chronic lymphocytic leukemia or small lymphocytic lymphoma, it may be combined with obinutuzumab.

Your doctor will decide if combination therapy is right for you based on your diagnosis and overall health.

Commonly tested with

In clinical studies, acalabrutinib has been tested both as a single agent (monotherapy) and in combination with other medications such as bendamustine, rituximab, and obinutuzumab. These combinations are used to enhance the effectiveness of treatment in certain blood cancers.

Your healthcare team may also monitor your blood counts and organ function regularly while you are on acalabrutinib to ensure safety and effectiveness.