What is calquence? Understanding this targeted cancer therapy

October 11, 2025 •

3 min read

First approved by the FDA in 2017 for mantle cell lymphoma, calquence (acalabrutinib) is a targeted oral medication used to treat certain B-cell malignancies. It is not a traditional chemotherapy drug but a Bruton's tyrosine kinase (BTK) inhibitor, a class of targeted therapies that work by interrupting specific signaling pathways within cancer cells. This targeted approach aims to limit the negative effects on healthy cells, offering a more precise treatment method.

Quick Summary

Calquence (acalabrutinib) is a targeted cancer therapy that works by inhibiting Bruton's tyrosine kinase (BTK). It is used to treat adult patients with specific blood cancers like chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL).

Key Points

BTK Inhibitor: Calquence (acalabrutinib) is a targeted oral medication that inhibits Bruton's tyrosine kinase (BTK), a protein vital for the growth of certain cancer cells.
Blood Cancer Treatment: It is prescribed for adults with chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), and mantle cell lymphoma (MCL).
Twice-Daily Dosing: The standard dose is one 100 mg tablet taken orally every 12 hours until disease progression or unacceptable toxicity.
Fewer Off-Target Effects: As a second-generation BTK inhibitor, Calquence is highly selective, which can result in a more favorable side effect profile compared to older inhibitors like ibrutinib.
Monitor for Bleeding and Infection: Serious side effects can include bleeding and infections. Patients should report any unusual signs to their doctor immediately.
Potential Drug Interactions: Calquence interacts with numerous medications and supplements, especially those affecting the CYP3A enzyme, as well as some gastric acid reducers.
Not Chemotherapy: It is a targeted therapy, not a traditional chemotherapy drug, and works by disrupting specific cancer pathways.

Understanding Calquence (Acalabrutinib)

Calquence (acalabrutinib) is a prescription oral medication that targets Bruton's tyrosine kinase (BTK), a protein important for the growth and survival of certain cancer cells. It is a targeted therapy, distinguishing it from traditional chemotherapy. Calquence is classified as a kinase inhibitor, specifically targeting BTK. Manufactured by AstraZeneca, it is available as a 100 mg oral tablet taken twice daily.

How Calquence Works (Mechanism of Action)

Calquence works by blocking BTK, a protein critical for the B-cell receptor signaling pathway. In blood cancers like chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL), this pathway is essential for malignant B-cells to grow and survive. By binding to BTK, Calquence disrupts this signaling, leading to the death of cancerous B-cells. Calquence is a highly selective BTK inhibitor with minimal off-target activity, which may result in a more favorable side effect profile compared to older BTK inhibitors.

What Conditions Does Calquence Treat?

Calquence is approved for treating specific adult B-cell malignancies. Its use and combinations depend on the patient's condition and history.

Calquence is indicated for:

Chronic Lymphocytic Leukemia (CLL) or Small Lymphocytic Lymphoma (SLL): For adult patients with CLL or SLL.
Mantle Cell Lymphoma (MCL): For adult patients with previously treated MCL, or in combination with bendamustine and rituximab for previously untreated MCL patients not eligible for autologous hematopoietic stem cell transplantation.

Dosage and Administration

The usual dose is one 100 mg Calquence tablet taken orally twice daily, approximately 12 hours apart. It should be swallowed whole with water, and can be taken with or without food. Treatment continues until disease progression or unacceptable side effects occur. Consistent dosing is important for continuous BTK inhibition.

Side Effects of Calquence

Calquence can cause side effects. {Link: Drugs.com https://www.drugs.com/calquence.html} provides information on common side effects, which may include headache, diarrhea, fatigue, musculoskeletal pain, bruising, nausea, and upper respiratory tract infection. Serious side effects like infections, hemorrhage, decreased blood cell counts, cardiac arrhythmias, and a risk of developing other cancers have also been reported. Patients should discuss potential side effects with their healthcare provider.

Comparing Calquence to Other BTK Inhibitors

Calquence, a second-generation BTK inhibitor, is often compared to the first-generation inhibitor ibrutinib and another second-generation inhibitor, zanubrutinib. Information on BTK selectivity, mechanism, cardiovascular risks, common side effects, tolerability, and efficacy for these drugs can be found on {Link: Drugs.com https://www.drugs.com/calquence.html}.

Important Warnings and Drug Interactions

Inform your doctor about all medications and supplements before starting Calquence.

CYP3A Interactions: Calquence is metabolized by CYP3A. Strong inhibitors can increase Calquence levels (e.g., ketoconazole), while strong inducers can decrease them (e.g., rifampin).
Gastric Acid Reducers: Avoid proton pump inhibitors. Take H2-receptor antagonists at a different time.
Blood Thinners: Concomitant use can increase bleeding risk.
Herbal Supplements: Avoid St. John's wort.
Surgery: Your doctor may recommend stopping Calquence before and after surgery to reduce bleeding risk.

Conclusion

Calquence offers a targeted treatment option for specific B-cell malignancies, acting as a BTK inhibitor to disrupt cancer cell growth and survival. It is used for conditions like CLL, SLL, and MCL. While generally well-tolerated, potential side effects and drug interactions require careful medical monitoring. Ongoing research continues to evaluate its use and compare it to other treatments. Treatment decisions should be made in consultation with a healthcare provider. More information is available on the {Link: FDA.gov https://www.fda.gov/drugs/resources-information-approved-drugs/project-orbis-fda-approves-acalabrutinib-cll-and-sll}.

Frequently Asked Questions

No, Calquence is not a chemotherapy drug. It is a targeted therapy known as a Bruton's tyrosine kinase (BTK) inhibitor, which works by targeting and blocking specific proteins involved in cancer cell growth, rather than killing all rapidly dividing cells like traditional chemotherapy.

Both Calquence and ibrutinib are BTK inhibitors, but Calquence is a more selective inhibitor. Clinical trials have found that Calquence is generally better tolerated, with lower rates of cardiovascular side effects like atrial fibrillation and hypertension compared to ibrutinib, while maintaining similar efficacy in CLL.

Calquence should be taken orally as a 100 mg tablet twice a day, approximately 12 hours apart. You can take it with or without food, but you must swallow the tablet whole with a glass of water.

If you miss a dose by more than 3 hours, you should skip that dose and take your next dose at the regularly scheduled time. You should not take extra tablets to make up for a missed dose.

Yes, Calquence can cause serious side effects, including heart rhythm problems like atrial fibrillation or flutter. Patients should report any signs of an irregular heartbeat, dizziness, or chest discomfort to their healthcare provider.

Many medications can interact with Calquence, especially those that affect the CYP3A enzyme, such as certain antibiotics (e.g., rifampin), antifungals (e.g., ketoconazole), and HIV drugs. It also interacts with some stomach acid reducers and blood thinners. You must inform your doctor of all your medications.

Yes, bleeding problems have occurred in patients taking Calquence and can be serious. Patients should notify their doctor if they experience unusual bleeding, including nosebleeds, blood in their urine or stools, or severe bruising.

There is a risk of developing other cancers, known as second primary malignancies, during treatment with Calquence. The most common type is skin cancer, so patients should protect themselves from sun exposure and report any new or changing skin growths.