Advantage of Acalabrutinib over Ibrutinib?

[Ibru]

Doc may want my husband to change to Calquence after 7.5 years on ibrutnib, due to afib. What are the advantages of acalabrutinib? Disadvantages? Has anyone else made this transition? How did it go?

[cajunjeff]

Acalabrutinib appears to be just as effective as ibrutinib with less side effects all the way around, including less risk of cardiotoxicity.

I made the switch six months ago with no problems at all. I did reasonably well on ibrutinib but it raised my bp and gave me diarrhea. Both side effects improved with acalabrutinib.

We are all different though and some do so well on ibrutinib there is no reason to change.

[Ibru in reply to cajunjeff]

Did you experience a similar cost? My husband is on Medicare so covered by Wellcare and then usually a lot of the remainder is covered by foundations.

[Ibru in reply to cajunjeff]

Jeff- Did you have any time off in between drugs or was it an immediate switch?

[Agatesup]

I was on 420 mg of Imbruvica for 3.5 years and no problems until last March when I experienced higher blood pressure and body ache. After 6 weeks of no medication I was placed on Calquence (280 mg). I have since had a slight bowel problem, otherwise all has been well.

[danimal7777]

I left ibrutinib after a year due to side effects. After a short break, I started acalabrutinib. I couldn't be more pleased. All the troublesome side effects from ibrutinib cleared up, and I've had a higher energy level and no new troublesome side effects. I feel very fortunate.

[Hidden]

You should read The Emperor Of All Diseases: A Biography of Cancer. Great book. One big takeaway is that cancer cells are intelligent and always adapt to counteract the treatment being used to destroy them. When I read that, I wondered how I could be on Ibrutinib "indefinitely", meaning lifelong. My hematologist confirmed on Friday that I'll be on Ibrutinib for likely 6-7 years and then it will cease to be able to keep the CLL in remission. (This ties in with the takeaway from the above-cited book.) At that time, I'll switch to Acalabrutinib for either 3-4 years or 4-5 years, and then it will cease to be effective and I'll go on the next drug. Given that will put us 10 years down the road, there will be new drugs available as well so this is a dynamic process and timeline. Hang loose. He mentioned a new version called Pirtobrutinib - see the following article from The Lancet at thelancet.com/journals/lanc... other things, it confirms "resistance and intolerance" for patients on BTK inhibitors like Ibrutinib. That, among other reasons, is why we continue to have regular blood test. After 2.5 years on IBR, I am finally down to bloodwork every 2 months. Yay!

[DriedSeaweed in reply to Hidden]

I think it is Maladies not diseases. I liked it too.

[Hidden in reply to DriedSeaweed]

Correct: Emperor of All Maladies. Another foggy mental breakdown brought to you by Ibrutinib.😊

[narl in reply to Hidden]

I read that book several years ago it was a good read. The Emperor of all maladies is the title.