Dr. Seymour on the Safety of Acalabrutinib Vs Ibrutinib in Relapsed/Refractory CLL

John F. Seymour, M​BBS, FRACP, PhD, director, ​Integrated Haematology Department, clinical hematologist, associate director of Clinical Research, Peter MacCallum Cancer Centre, Victoria Australia, discusses the findings from a post-hoc analysis of the phase 3 ELEVATE-RR trial (NCT02477696) examining the adverse effects (AEs) experienced with the BTK inhibitors acalabrutinib (Calquence) and ibrutinib (Imbruvica) in patients with relapsed or refractory chronic lymphocytic leukemia (CLL).

Data from the analysis, which were presented during the 2021 ASH Annual Meeting, revealed that acalabrutinib was generally better tolerated than ibrutinib, with a lower cardiovascular-related toxicity burden observed, according to Seymour. The exposure-adjusted time with event with the cardiovascular AEs were two- to four-fold higher with ibrutinib vs acalabrutinib, particularly for hypertension and atrial fibrillation, Seymour adds. This was observed irrespective of age, number of prior therapies received, and prior history of AEs, Seymour explains.

Lower-grade AEs, such as diarrhea, arthralgias, back pain, muscle spasm, and dyspepsia, occurred 1.4 to 13 times more frequently in their exposure-adjusted incidence and exposure-adjusted time with event with ibrutinib compared with acalabrutinib, Seymour concludes.