Aaron Logan, MD, PhD, assistant professor of clinical medicine, University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, discusses acalabrutinib (Calquence) in chronic lymphocytic leukemia (CLL).

The development of more selective agents is a general theme that has emerged in novel therapies, says Logan. In many cases, there are off-target toxicities with ibrutinib (Imbruvica), such as atrial fibrillation, and some platelet inhibition, which can lead to bleeding events.

Logan says that a more targeted Bruton's tyrosine kinase (BTK) inhibitor than ibrutinib may have some advantages. The BTK inhibitor acalabrutinib was shown to have a more favorable side effect profile, but it is not yet clear that it is superior to ibrutinib. The role of acalabrutinib has yet to be established, Logan says, but it may be beneficial for patients who cannot tolerate ibrutinib or have contraindications, such as an arrhythmia.

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Aaron Logan, MD, PhD, assistant professor of clinical medicine, UCSF Helen Diller Family Comprehensive Cancer Center, discusses acalabrutinib (Calquence) in chronic lymphocytic leukemia.
 

Dr. Logan Discusses Acalabrutinib in CLL

Aaron Logan, MD, PhD, assistant professor of clinical medicine, UCSF Helen Diller Family Comprehensive Cancer Center, discusses the combination of ibrutinib (Imbruvica) and venetoclax (Venclexta) in chronic lymphocytic leukemia (CLL).

Results from the TAP CLARITY study showed that the ibrutinib plus venetoclax elicited a complete response (CR) or CR with incomplete hematologic recovery (CRi) rate of 47% for patients with relapsed/refractory CLL. Patients in the relapsed/refractory cohort achieved minimal residual disease (MRD) negativity after 1 year of combination targeted therapy.

Although the numbers are small, it looks like there are good responses, with all patients eventually developing MRD negativity with the combination of Bruton's tyrosine kinase (BTK) inhibition and BCL-2 inhibition. Logan says that he is not sure this combination will achieve immediate approval because it is not yet clear if the FDA is ready to use MRD as an endpoint for clinical trials.

Aaron Logan, MD, PhD, assistant professor of clinical medicine, UCSF Helen Diller Family Comprehensive Cancer Center, discusses the combination of ibrutinib (Imbruvica) and venetoclax (Venclexta) in chronic lymphocytic leukemia.

Dr. Logan Discusses Ibrutinib Plus Venetoclax in CLL

Aaron Logan, MD, PhD, assistant professor of clinical medicine, UCSF Helen Diller Family Comprehensive Cancer Center, discusses treatment options for patients with chronic lymphocytic leukemia (CLL).

CLL remains the most common leukemia in adults, says Logan. This has led to a lot of innovative therapy, such as monoclonal agents and chemoimmunothearpy.

Additionally, patients with genetic abnormalities such as 17p deletion and 

 now have targeted agents like venetoclax (Venclexta), as these mutations do not respond well to chemoimmunotherapy.

Aaron Logan, MD, PhD, assistant professor of clinical medicine, UCSF Helen Diller Family Comprehensive Cancer Center, discusses treatment options for patients with chronic lymphocytic leukemia.

Aaron Logan, MD, PhD

Articles

Dr. Logan Discusses Acalabrutinib in CLL

Dr. Logan Discusses Ibrutinib Plus Venetoclax in CLL

Dr. Logan Discusses Treatment Options in CLL