Calquence (acalabrutinib; AstraZeneca/Acerta) is a novel, orally available, second-generation Bruton’s tyrosine kinase (BTK) inhibitor with potential antineoplastic activity. Inhibition of the BTK protein prevents the activation of the B-cell antigen receptor signalling pathway, which blocks both B-cell activation and BTK-mediated activation of downstream survival pathways. This finally leads to an inhibition of the growth of malignant B cells that overexpress BTK and, in many instances, causes the death of these cells. Calquence is being developed for the treatment of various blood cancers and solid tumours, as well as rheumatoid arthritis.
Calquence (acalabrutinib; AstraZeneca/Acerta) is a second-generation Bruton’s tyrosine kinase (BTK) inhibitor currently being investigated in Phase III trials for the treatment of patients with high-risk relapsed/refractory chronic lymphocytic leukaemia (CLL) with 17p or 11q deletions, and previously untreated patients. Patients with 17p or 11q deletions generally have a poor prognosis and remain an area of high unmet need. If approved, Calquence could potentially be the second BTK inhibitor to reach the market, after AbbVie’s Imbruvica (ibrutinib). Calquence will need to show a clear advantage over Imbruvica in terms of efficacy and/or tolerability in order to be successful in the CLL market.
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Calquence: Chronic lymphocytic leukemia (CLL)
Figure 2: Calquence sales for CLL across the US and five major EU markets, by country, 2017–26
Table 2: Trials of Calquence for CLL
Table 3: Calquence for CLL – SWOT analysis