Abstract
Acalabrutinib (ACP-196) is a second-generation inhibitor of Bruton agammaglobulinemia tyrosine kinase (BTK) with increased target selectivity and potency compared to ibrutinib. In this study, we evaluated acalabrutinib in spontaneously occurring canine lymphoma, a model of B-cell malignancy similar to human diffuse large B-cell lymphoma (DLBCL). First, we demonstrated that acalabrutinib potently inhibited BTK activity and downstream effectors in CLBL1, a canine B-cell lymphoma cell line, and primary canine lymphoma cells. Acalabrutinib also inhibited proliferation in CLBL1 cells. Twenty dogs were enrolled in the clinical trial and treated with acalabrutinib at dosages of 2.5 to 20mg/kg every 12 or 24 hours. Acalabrutinib was generally well tolerated, with adverse events consisting primarily of grade 1 or 2 anorexia, weight loss, vomiting, diarrhea and lethargy. Overall response rate (ORR) was 25% (5/20) with a median progression free survival (PFS) of 22.5 days. Clinical benefit was observed in 30% (6/20) of dogs. These findings suggest that acalabrutinib is safe and exhibits activity in canine B-cell lymphoma patients and support the use of canine lymphoma as a relevant model for human non-Hodgkin lymphoma (NHL).
MeSH terms
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Agammaglobulinaemia Tyrosine Kinase
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Animals
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Anorexia / chemically induced
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Anorexia / physiopathology
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Antineoplastic Agents / administration & dosage*
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Antineoplastic Agents / adverse effects
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B-Lymphocytes / drug effects
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B-Lymphocytes / immunology
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B-Lymphocytes / pathology
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Benzamides / administration & dosage*
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Benzamides / adverse effects
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Cell Line, Tumor
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Diarrhea / chemically induced
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Diarrhea / physiopathology
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Disease Models, Animal
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Disease-Free Survival
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Dogs
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Drug Administration Schedule
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Drug Evaluation, Preclinical
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Female
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Humans
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Lethargy / chemically induced
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Lethargy / physiopathology
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Lymphoma, Large B-Cell, Diffuse / drug therapy*
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Lymphoma, Large B-Cell, Diffuse / enzymology
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Lymphoma, Large B-Cell, Diffuse / mortality
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Lymphoma, Large B-Cell, Diffuse / veterinary*
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Male
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Protein Kinase Inhibitors / administration & dosage*
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Protein Kinase Inhibitors / adverse effects
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Protein-Tyrosine Kinases / antagonists & inhibitors*
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Protein-Tyrosine Kinases / genetics
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Protein-Tyrosine Kinases / metabolism
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Pyrazines / administration & dosage*
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Pyrazines / adverse effects
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Vomiting / chemically induced
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Vomiting / physiopathology
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Weight Loss / drug effects
Substances
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Antineoplastic Agents
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Benzamides
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Protein Kinase Inhibitors
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Pyrazines
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Protein-Tyrosine Kinases
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Agammaglobulinaemia Tyrosine Kinase
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BTK protein, human
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acalabrutinib