Dr. Shah Compares Toxicity Profiles of Ibrutinib and Acalabrutinib

Bijal D. Shah, MD, medical oncologist, Moffitt Cancer Center, assistant professor of oncology, University of South Florida, compares toxicity profiles of ibrutinib (Imbruvica) and acalabrutinib (Calquence).

Some initial thoughts are that acalabrutinib is associated with less bleeding and adverse events (AEs), Shah says. While there was less severe bleeding compared with patients treated with ibrutinib, there are some factors to take into consideration. Slightly less patients were anticoagulated. In terms of minor bleeding rates like contusion and petechiae, the 2 BTK inhibitors were similar. Shah says that he wouldn’t make a decision of which agent is better solely based on toxicity profiles.

Another important observation is that roughly half of patients treated with ibrutinib were still on anticoagulation compared with 40% of the acalabrutinib group. If physicians want to anticoagulate, they can as long as they’re aware of the risk. In terms of more acalabrutinib-specific AEs, there was more headache and atrial fibrillation.