Jennifer Woyach, MD, associate professor, The Ohio State University, discusses a 3-year follow-up looking at acalabrutinib (Calquence) with obinutuzumab (Gazyva) in treatment-naïve and relapsed/refractory chronic lymphocytic leukemia (CLL).

BTK inhibition is very effective in CLL. Acalabrutinib, a second-generation irreversible BTK inhibitor, hits the same target as ibrutinib and other irreversible inhibitors, but is a little more selective, according to Woyach. There is also minimal off-target activity, which is important for the safety profile and interactions with the antibodies. In this trial, acalabrutinib was combined with obinutuzumab, a CD20 monoclonal antibody, with the endpoints of complete response rates and progression-free survival.

In the 3.5-year follow-up on this study, 19 patients have treatment-naïve CLL and 26 patients have relapsed/refractory disease. After 3.5 years, 78% of patients remain on treatment and progression free. In the treatment-naïve cohort, about 94% of patients are progression free and alive. In the relapsed/refractory cohort, 73% of patients are still alive and progression free.