Calquence (acalabrutinib) vs Brukinsa (zanubrutinib)

Calquence (acalabrutinib) and Brukinsa (zanubrutinib) are both Bruton's tyrosine kinase (BTK) inhibitors used to treat certain types of B-cell malignancies, such as mantle cell lymphoma and chronic lymphocytic leukemia. Acalabrutinib is known for its selective inhibition of BTK, potentially resulting in fewer off-target effects, while zanubrutinib has a higher affinity for BTK, which may translate to more potent BTK inhibition but also a higher risk of side effects. When deciding between the two, it is important to consider individual patient factors, including the specific indication, previous treatments, potential drug interactions, and the side effect profile, in consultation with a healthcare provider.

Difference between Calquence and Brukinsa

Metric	Calquence (acalabrutinib)	Brukinsa (zanubrutinib)
Generic name	Acalabrutinib	Zanubrutinib
Indications	Chronic lymphocytic leukemia (CLL), Small lymphocytic lymphoma (SLL), Mantle cell lymphoma (MCL)	Mantle cell lymphoma (MCL), Waldenström's macroglobulinemia
Mechanism of action	Bruton's tyrosine kinase (BTK) inhibitor	Bruton's tyrosine kinase (BTK) inhibitor
Brand names	Calquence	Brukinsa
Administrative route	Oral	Oral
Side effects	Headache, diarrhea, muscle pain, bruising, fatigue, anemia	Decreased neutrophil count, upper respiratory tract infection, decreased platelet count, hemorrhage
Contraindications	History of severe bleeding, coagulation disorders	None specifically listed; use caution in patients with bleeding risk or those taking anticoagulants
Drug class	BTK inhibitor	BTK inhibitor
Manufacturer	AstraZeneca	BeiGene

Efficacy

Calquence (Acalabrutinib) Efficacy in Lymphoma

Calquence, with the active ingredient acalabrutinib, is a second-generation Bruton's tyrosine kinase (BTK) inhibitor. It has demonstrated efficacy in treating certain types of lymphoma, particularly mantle cell lymphoma (MCL), which is a subtype of non-Hodgkin lymphoma. Clinical trials have shown that acalabrutinib can lead to high response rates in patients with relapsed or refractory MCL. The drug has been approved by regulatory agencies for the treatment of MCL after the failure of at least one prior therapy. Its efficacy is attributed to its ability to inhibit the BTK enzyme, which plays a crucial role in the survival and proliferation of malignant B cells.

While acalabrutinib is not currently approved for other types of lymphoma, ongoing clinical trials are investigating its potential use in various other B-cell malignancies. The drug's selectivity and targeted mechanism of action offer a promising treatment option for patients with B-cell lymphomas, and further research may expand its indications within the lymphoma category.

Brukinsa (Zanubrutinib) Efficacy in Lymphoma

Brukinsa, containing zanubrutinib as its active ingredient, is another next-generation BTK inhibitor with demonstrated efficacy in treating B-cell malignancies. Zanubrutinib has been studied in several types of lymphoma, including MCL, Waldenström's macroglobulinemia (WM), and marginal zone lymphoma (MZL). In clinical trials, zanubrutinib has shown a high overall response rate in patients with relapsed or refractory MCL, leading to its approval for this indication. Additionally, its efficacy in WM and ongoing studies in other lymphoma subtypes suggest a broader therapeutic potential for zanubrutinib in the treatment of B-cell lymphomas.

Compared to the first-generation BTK inhibitors, zanubrutinib is designed to be more selective with a higher affinity for BTK, potentially leading to fewer off-target effects and improved tolerability. This selectivity, combined with its robust anti-tumor activity, makes Brukinsa a valuable addition to the treatment landscape for patients with B-cell lymphomas. As with acalabrutinib, further research and clinical trials will continue to define the role of zanubrutinib in the management of various lymphoma subtypes.

Regulatory Agency Approvals

Calquence

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Health Canada
Pharmaceuticals and Medical Devices Agency (PMDA), Japan
Therapeutic Goods Administration (TGA), Australia

Brukinsa

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA

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