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Acalabrutinib MCL Approval Raises Sequencing Questions

Angelica Welch
Published: Wednesday, Nov 15, 2017

Owen A. O'Connor, MD, PhD

Owen A. O'Connor, MD, PhD
The October 2017 FDA approval of acalabrutinib (Calquence) for patients with mantle cell lymphoma (MCL) added another BTK inhibitor to the armamentarium while contributing to the growing discussion of sequencing with other available agents, explained Owen A. O'Connor, MD, PhD.

, O’Connor, professor of medicine and experimental therapeutics, director of the Center for Lymphoid Malignancies, co-program director of the Lymphoid Development and Malignancy Program in the Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center, discussed the utilization of acalabrutinib, how it sequences with other approved therapies, and the promise for CAR T-cell therapy in MCL.

OncLive: Could you comment on the recent FDA approval of acalabrutinib in MCL?

O’Connor: Bortezomib (Velcade) was the first drug ever approved for MCL more than 20 years ago. There have been gigantic leaps in our ability to refine treatment ideas and treatment recommendations for specific patients. One of the big advances that we have made came biologically, which was recognizing that MCL is not one disease. Many of the studies that we do—even the more recent ones—tend to lump all patients into one pot. Increasingly, we recognize that the proliferative rate of Ki-67 is an important determinate for many patients. Those with aggressive disease might benefit from more aggressive therapy upfront versus patients with less aggressive disease, who we can maybe take a more conservative approach like we are used to doing in patients with indolent follicular lymphoma.
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