Summary

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• Acalabrutinib (Calquence) is recommended for the treatment of adult patients with mantle cell lymphoma (MCL) and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), especially those who have undergone at least one previous therapy.
• Three studies were evaluated, two focusing on CLL/SLL and one on MCL, providing insights into acalabrutinib's safety and effectiveness compared to other options.
• Regarding effectiveness, acalabrutinib demonstrates significant improvement in progression-free survival over standard treatments including bendamustine + rituximab and chlorambucil-based therapy among others. It also shows a higher overall response rate than ibrutinib and other targeted therapies such as bortezomib, lenalidomide, temsirolimus in the relapsed/refractory MCL setting.
• Acalabrutinib has a favorable safety profile with fewer high-grade adverse events compared to treatments within its class like ibrutinib or zanubrutinb. Adverse events mainly include cytopenia and hypertension but are generally manageable.
• Individuals younger than 65 years or those treated with combination therapy involving BTKi displayed higher effectiveness according to the studies. Treatment-naive individuals especially benefit from this drug, particularly for CLL/SLL indication.
• The overall analysis underscores acalabrutinib's valuable role in treating these complex hematologic malignancies, advocating for its usage based on current evidence, especially in patients who have received prior therapy or in combination treatment settings.