Leukemia (CLL)

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How Is Calquence Used For Chronic Lymphocytic Leukemia?

Sheryl Ness BSN, MA, RN

Calquence Info

  • Calquence (acalabrutinib) is a newly approved targeted therapy for chronic lymphocytic leukemia (CLL) that is newly diagnosed or has recurred
  • Two clinical trials found that it was more effective than other available oral treatments
  • It’s hoped that patients taking Calquence will experience fewer side effects than with ibrutinib, (brand name Imbruvica) another drug in the same class
  • Calquence and other oral therapies may allow patients with CLL to avoid intravenous chemotherapy

Calquence (acalabrutinib) is a new oral therapy for chronic lymphocytic leukemia (CLL). The new drug gives patients with this type of leukemia an alternative to intravenous chemotherapy. Unlike traditional chemotherapy, Calquence is a targeted therapy, which means that it delays or prevents the growth of cancer cells rather than destroying them. The drug was approved as therapy for both previously untreated CLL as well as relapsed CLL.

Based on two clinical trials that led to the drug’s recent FDA approval, Calquence is more effective, with no more–and possibly fewer–side effects than other available oral treatments. In one trial, 82 percent of patients with relapsed or refractory (resistant to treatment) CLL treated with Calquence remained progression free a year and a half into followup, versus 48 percent of those taking other drugs used to treat the disease. Calquence is given in capsule form, and the usual dose is one capsule twice a day.

“Over the past several years the treatment landscape has dramatically changed and remarkably improved for patients with CLL,” says Dr. Nicole Lamanna, a leukemia specialist at Columbia University Medical Center in New York City. “It’s hoped that Calquence will decrease some of the adverse side effects, such as atrial fibrillation and bleeding issues, seen with ibrutinib, (brand name Imbruvica) another drug in the same class.”

About Calquence
Calquence was initially approved in 2017 as a breakthrough treatment for a rare type of cancer called mantle cell lymphoma. The drug is in a class called  Bruton tyrosine kinase (BTK) inhibitor. These drugs work by blocking a special protein enzyme–BTK–that controls how quickly some cells multiply. Blocking the enzyme keeps abnormal cancer cells from growing further.

While it’s obviously easier for patients to swallow a capsule rather than report to an infusion center for intravenous chemotherapy, Calquence is still powerful anti-cancer medicine. It’s important for patients to follow their doctor’s instructions on how and when to take the drug. And, as with many other medications, there are potential side effects. These include:

  • headache
  • diarrhea
  • muscle and joint pain
  • upper respiratory infections
  • bruising

“Most side effects decrease over time, and this therapy can certainly be given to older patients with CLL,” says Dr. Lamanna. Patients taking Calquence should stay in close contact with their cancer doctor and report any serious problems right away. Some patients may need to reduce the dosage or temporarily stop taking the drug based on the seriousness of their symptoms.

When Should Patients Consider Taking Calquence?

Calquence is approved for both newly diagnosed and relapsed CLL.

CLL is the most common type of adult leukemia, with over 20,000 Americans, most of them older, diagnosed with the disease each year. CLL begins in the white blood cells called B lymphocytes, spreading out from the bone marrow and into the bloodstream, often moving into organs such as the liver and spleen. CLL is a slow-moving cancer that often progresses so slowly that people can be symptom-free for years before diagnosis and treatment.

When symptoms  of CLL do occur, they can include fatigue, shortness of breath, anemia, enlarged lymph nodes, enlarged spleen or liver, and night sweats, among others. Patients are monitored with blood tests and other lab work that indicate when it’s necessary to begin treatment.

[Related: Determining When Treatment is Needed (Video)]

Living with CLL
Over time, CLL patients may have been given many different types of maintenance chemotherapy in order to keep their leukemia under control. This constant treatment takes a toll on both the physical and emotional health of patients.

Oral medications such as Calquence may offer patients a longer remission, improved quality of life, and possibly a long-term management treatment option. If you are living with CLL, your doctor can recommend whether Calquence or another new CLL oral treatment is right for you.


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Treatment: Oral Medications

For patients diagnosed with CLL, the go-to treatment option is usually some form of chemo-immunotherapy. But this is not an option for all patients.


Oral Medicine for Relapsed CLL: Venetoclax


Oral Medicine for CLL: Ibrutinib


Oral Medicine for Relapsed CLL

Dr. Matthew Davids
Dana-Farber Cancer Institute