Chronic lymphocytic leukemia (CLL), is a type of cancer that affects a type of white blood cell in your body called a lymphocyte. White blood cells are made in your bone marrow and help your body fight infections. In people with CLL, their bone marrow makes too many lymphocytes that do not work as they should. Some people may not have symptoms at first. Others may have symptoms and may have the disease spread to their lymph nodes, liver, and spleen.
Calquence (KAL-kwens) was approved for the treatment of CLL in 2019. It has been shown to lower the risk that CLL will grow and spread throughout your body.
How Does It Work for CLL?
CLL may have the following symptoms:
- Tiredness
- Shortness of breath, especially while doing normal physical activities
- Low red blood cell count (anemia)
- Swollen lymph nodes in the neck
- Fever
- Weight loss
- Night sweats
- Pain or fullness in your stomach
- Infections
There is no cure for CLL, but the disease can be managed with medicine and chemotherapy. Calquence falls into a group of medicines called targeted therapies. A targeted therapy is one that targets a specific protein inside cancer cells, which helps stop the cancer cells from growing and spreading. Targeted therapy may be part of first-line treatment for CLL. A first-line therapy is a medicine that your health care provider can try first.
Calquence is also classified as a Bruton tyrosine kinase (BTK) inhibitor. BTK is a protein that can cause cancer cells to grow. Calquence works to block the BTK protein, which stops cancer cells from growing.
How Do I Take It?
Calquence is taken twice a day, about 12 hours between each dose, with or without food. Calquence comes in tablets and capsules. Do not open, crush, chew, or break the tablets and capsules. Swallow the tablet or capsule whole. Calquence only comes in a 100-milligram dose.
How Was It Studied?
Two studies were done on people with CLL to test the safety and efficacy of Calquence.
In the first study, people took one of the following:
- Calquence and obinutuzumab, which is another medicine for CLL and other cancers
- Calquence by itself
- Obinutuzumab and another medicine called chlorambucil, which is a medicine used to treat CLL and other cancers.
The study looked at progression-free survival. Progression-free survival is the amount of time it takes for your cancer to get worse after you start a certain medicine. The median age was 70 years old.
In the second study, people with CLL who had at least one systemic therapy, which is a treatment that targets the entire body, received either Calquence or a cancer medicine that the study investigators chose. This was either idelalisib plus a rituximab or bendamustine plus a rituximab. The study looked at progression-free survival. The median age was 68 years old.
What Benefits Were Seen?
In the first study, at the median follow-up time of 28 months, the median progression-free survival was longer in the Calquence-obinutuzumab group and Calquence group (not yet reached) compared to the obinutuzumab-chlorambucil group (22.6 months).
In the second study, at the median follow-up time of 16 months, the median progression-free survival was longer in the Calquence group (not yet reached) compared to the Investigators’ choice medicines (16.5 months).
This meant that people with CLL taking Calquence had their condition remain stable for a longer period of time.
How Can I Tell if It Is Working?
Calquence starts to work as soon as you start taking the medicine. If you have symptoms due to your CLL, you may start to see them lessen or your condition start to stabilize. Calquence can help keep your CLL from worsening. Keep all appointments with your health care provider while taking Calquence. Call your health care provider if you have new symptoms. Your health care provider will determine if they will keep you on Calquence, add on another medicine, or switch you to a completely different medicine.
What Are the Possible Side Effects, and How Can I Manage Them?
The most common side effects seen with Calquence are:
- Low red blood cells (anemia)
- Low levels of white blood cells called neutrophils (a condition called neutropenia)
- Infection in the nose or throat, a sore throat, or common cold symptoms
- Low platelets, which help clot your blood (a condition called thrombocytopenia)
- Headache
- Diarrhea
- Muscle or joint pain
- Bruising
Taking Calquence can cause changes to your blood tests, including low levels of red blood cells, neutrophils, and platelets. Keep all appointments with your health care provider to have your blood checked. Your health care provider may monitor your blood levels while you are taking Calquence.
Call your health care provider if you have cold symptoms or have muscle or joint pain. Your health care provider will advise you on how to best manage your symptoms, including if you need to keep over-the-counter medicines on hand.
If you have headaches while taking Calquence, keeping over-the-counter medicines such as ibuprofen or Tylenol may help. Call your health care provider if your headaches do not go away or get worse.
You may get diarrhea while you are taking Calquence. To limit diarrhea, you can try simple steps such as eating bland foods like rice, bananas, and toast; drinking plenty of water; and lowering the amount of caffeine you are drinking. Call your health care provider if your diarrhea symptoms are not improving or are getting worse. Your health care provider may prescribe you prescription medicines to treat this or may ask you to keep over-the-counter medicines on hand.
You may have bruising while taking Calquence. Putting ice on your bruises and raising the area can help if you get swelling and tenderness.
What Types of Drug Interactions Can Happen?
Certain medicines can potentially affect the blood levels of Calquence. It may not be recommended to take Calquence with these medicines, or your health care provider may change the dose of Calquence. Tell your health care provider about all the prescription medicines, over-the-counter medicines, vitamins, and supplements you are taking. Your health care provider can find out if any of the medicines you are taking may interact with Calquence.
Calquence comes in tablets and capsules. If you are taking Calquence capsules, it is not recommended to use proton pump inhibitors, such as esomeprazole (Nexium) and omeprazole (Prilosec). If you take antacids, it is recommended to take them either 2 hours before or 2 hours after taking Calquence capsules. If you are taking an H2-receptor antagonist medicine, such as cimetidine (Tagamet) or famotidine (Pepcid), it is recommended to take Calquence capsules at least 2 hours before taking the H2-receptor antagonist medicine.
Is There a Cost Savings Program?
There is a copay savings program available from the drugmaker that may allow you to pay as little as $0 per month on your Calquence prescription. Whether you are eligible depends on the type of insurance you have. You can find out more by visiting www.calquence.com/financial-support/commercially-insured.html or by calling 844-275-2360.
