Email this article ELEVATE-RR – first head-to-head trial of acalabrutinib versus ibrutinib in previously treated high risk chronic lymphocytic leukemia
- Authors: Bialik T.E.1, Vorob'ev V.I.2, Ionin V.A.3,4, Ysebaert L.5, Kaplanov K.D.2, Mendeleeva L.P.6, Nikitin E.A.7, Ptushkin V.V.8,9, Samoilova O.S.10, Stadnik E.A.3
-
Affiliations:
- Blokhin National Medical Research Center of Oncology
- Botkin City Clinical Hospital
- Pavlov First Saint Petersburg State Medical University
- Almazov National Medical Research Centre
- Toulouse Cancer Center
- National Medical Research Center for Hematology
- Russian Medical Academy of Continuous Professional Education
- Pirogov Russian National Research Medical University
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology
- Semashko Nizhny Novgorod Regional Clinical Hospital
- Issue: Vol 23, No 3 (2021)
- Pages: 404-406
- Section: CLINICAL ONCOLOGY
- URL: https://journals.rcsi.science/1815-1434/article/view/88010
- DOI: https://doi.org/10.26442/18151434.2021.3.201207
- ID: 88010
Cite item
Full Text
Abstract
Over the past decades, there has been a significant expansion of the treatment options for patients with chronic lymphocytic leukemia (CLL) due to Bruton’s tyrosine kinase (BTK) inhibitors, which changed approaches in CLL therapy. Ibrutinib was the first BTK inhibitor approved for CLL treatment, but adverse events such as atrial fibrillation and hypertension may limit the use of ibrutinib. In the first head-to-head trial of acalabrutinib and ibrutinib ELEVATE-RR, acalabrutinib was statistically superior to ibrutinib in all-grade atrial fibrillation/flutter (9.4% vs 16.0%; р=0.023). In all-grade arterial hypertension (9.4% vs 23.2%) and grade ≥3 (4.1% vs 9.1%) acalabrutinib was statistically superior to ibrutinib. Acalabrutinib demonstrated fewer discontinuations due to adverse events (14.7%) vs ibrutinib (21.3%). Based on ELEVATE-RR results acalabrutinib should be considered as a drug of choice among BTK inhibitors for CLL patients, including patients with cardiovascular diseases and risks of cardiovascular diseases.
Full Text
##article.viewOnOriginalSite##About the authors
Tatiana E. Bialik
Blokhin National Medical Research Center of Oncology
Author for correspondence.
Email: editor@consiliummedicum.ru
Cand. Sci. (Med.)
Russian Federation, MoscowVladimir I. Vorob'ev
Botkin City Clinical Hospital
Email: editor@consiliummedicum.ru
Cand. Sci. (Med.)
Russian Federation, MoscowValerii A. Ionin
Pavlov First Saint Petersburg State Medical University; Almazov National Medical Research Centre
Email: editor@consiliummedicum.ru
Cand. Sci. (Med.)
Russian Federation, Saint PetersburgLoic Ysebaert
Toulouse Cancer Center
Email: editor@consiliummedicum.ru
ORCID iD: 0000-0003-4102-7261
M.D., Prof.
France, ToulouseKamil D. Kaplanov
Botkin City Clinical Hospital
Email: editor@consiliummedicum.ru
ORCID iD: 0000-0001-6574-0518
Cand. Sci. (Med.)
Russian Federation, MoscowLarisa P. Mendeleeva
National Medical Research Center for Hematology
Email: editor@consiliummedicum.ru
ORCID iD: 0000-0002-4966-8146
D. Sci. (Med.), Prof.
Russian Federation, MoscowEvgenii A. Nikitin
Russian Medical Academy of Continuous Professional Education
Email: editor@consiliummedicum.ru
D. Sci. (Med.), Prof.
Russian Federation, MoscowVadim V. Ptushkin
Pirogov Russian National Research Medical University; Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology
Email: editor@consiliummedicum.ru
ORCID iD: 0000-0002-9368-6050
D. Sci. (Med.), Prof.
Russian Federation, MoscowOlga S. Samoilova
Semashko Nizhny Novgorod Regional Clinical Hospital
Email: editor@consiliummedicum.ru
Cand. Sci. (Med.)
Russian Federation, Nizhny NovgorodElena A. Stadnik
Pavlov First Saint Petersburg State Medical University
Email: editor@consiliummedicum.ru
Cand. Sci. (Med.)
Russian Federation, Saint PetersburgReferences
- Wu J, Zhang M, Liu D. Acalabrutinib (ACP-196): a selective second-generation BTK inhibitor. J Hematol Oncol. 2016;9:21.
- Wendtner CM. Ibrutinib: the home run for cure in CLL? Blood. 2019;133(19):2003-4.
- Patel V, Balakrishnan K, Bibikova E, et al. Comparison of acalabrutinib, a selective Bruton tyrosine kinase inhibitor, with ibrutinib in chronic lymphocytic leukemia cells. Clin Cancer Res. 2017;23(14):3734-43.
- Giudice V. Cardiotoxicity of Novel Targeted Hematological Therapies. Life. 2020;10:344. doi: 10.3390/life10120344
- Shanafelt TD, Parikh SA, Noseworthy PA, et al. Atrial fibrillation in patients with chronic lymphocytic leukemia (CLL). Leuk Lymphoma. 2017;58(7):1630-9.
- Caldeira D, Alves D, Costa J, et al. Ibrutinib increases the risk of hypertension and atrial fibrillation: Systematic review and meta-analysis. PLoS One. 2019;14:e0211228.
- Benjamin EJ, Wolf PA, D’Agostino RB, et al. Impact of atrial fibrillation on the risk of death: The Framingham heart study. Circulation. 1998;98:946-52.
- Chai KL, Rowan G, Seymour JF, et al. Practical recommendations for the choice of anticoagulants in the management of patients with atrial fibrillation on ibrutinib. Leuk Lymphoma. 2017;58:2811-4.
- Byrd JC, Harrington B, O’Brien S, et al. Acalabrutinib (ACP-196) in relapsed chronic lymphocytic leukemia. N Engl J Med. 2016;374(4):323-32.
- Byrd JC, Hillment P, Gia P, et al. First results of a head-to-head trial of acalabrutinib versus ibrutinib in previously treated chronic lymphocytic leukemia. Oral abstract №7500. 2021 American Society of Clinical Oncology (ASCO) Annual Meeting. 2021.
- Byrd JC, Hillmen P, Ghia P, et al. Acalabrutinib versus ibrutinib in previously treated chronic lymphocytic leukemia: results of the first randomized phase III trial. J Clin Oncol. 2021:JCO2101210. doi: 10.1200/JCO.21.01210
