Acalabrutinib is a novel oral anti‐cancer drug in clinical development for people with chronic lymphocytic leukaemia (CLL) who have not received any previous treatment. CLL is a type of
cancer in which too many white blood cells are produced. As these cells develop abnormally, they are unable to function and fight infection and reduce the production of healthy blood
cells. The disease is chronic and develops slowly. Treatment for CLL is complex and depends on a number of factors, including extent of disease, previous treatment, patient’s age,
symptoms and general state of health. Patients whose CLL is not causing any symptoms or is getting worse only very slowly may not need treatment. Treatment for CLL is started only if
symptoms become troublesome.
Acalabrutinib works by blocking a specific enzyme referred to as Bruton’s Tryrosine Kinase, to slow the build‐up of cancerous cells in CLL, thereby delaying or stopping the progression
of the disease. The Bruton’s Tryrosine Kinase enzyme has been identified as an important therapeutic target for the treatment of CLL. Acalabrutinib is thought to be a more selective
and irreversible blocker of this enzyme and is specifically designed to improve on the safety and efficacy of first generation inhibitors. If licensed, acalabrutinib will offer an additional
first‐line treatment option for adult patients who have CLL. It may expand the first‐line treatment options for elderly patients or those less than 65years who are deemed as unfit.
Nivolumab works by improving the activity of white blood cells thereby increasing the ability of the immune system to kill cancer cells. Cabozantinib works to stop signals that cancer cells use to divide and grow. It is thought that when used in combination, both drugs may be more effective than each drug on its own. If licenced, nivolumab in combination with cabozantinib may improve long-term outcomes in mRCC patients who currently have limited treatment options.