Dr. Wierda on the ASCEND Trial and BTK Inhibitor-Based Therapies in CLL

William G. Wierda, MD, PhD, professor, D. B. Lane Cancer Research Distinguished Professor, section chief of Chronic Lymphocytic Leukemia, center medical director, Department of Leukemia, Division of Cancer Medicine, and executive medical director, The University of Texas MD Anderson Cancer Center, discusses the use of BTK inhibitors in chronic lymphocytic leukemia (CLL).

In the phase III ASCEND trial, investigators reported a significant improvement in progression-free survival (PFS) with acalabrutinib (Calquence) compared withrituximab (Rituxan) plus physician’s choice of idelalisib (Zydelig) or bendamustine in patients with previously treated disease. At a median follow-up of 16.1 months, PFS was not reached with acalabrutinib versus 16.5 months in the physician’s choice control arm (HR, 0.31; 95% CI, 0.20-0.49; P <.0001).

These data demonstrate the benefit of BTK based therapy, says Wierda.

For relapsed/refractory patients, acalabrutinib could provide patients with an alternative to ibrutinib (Imbruvica). In terms of toxicity, acalabrutinib has shown a lower rate of fatigue, arthralgia, and myalgia compared with ibrutinib. Therefore, the use of acalabrutinib may lead to less dose adjustment or discontinuation versus ibrutinib.