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EHA 2026 | Practical considerations for using acalabrutinib in elderly patients with CLL
Florian Simon, MD, University Hospital Cologne, Cologne, Germany, discusses practical considerations for using acalabrutinib in elderly patients with chronic lymphocytic leukemia (CLL). He emphasizes balancing clinical trial and real-world evidence, monitoring for treatment discontinuation and cardiovascular toxicities, and using available data to support shared decision-making with patients. This interview took place at the 31st Congress of the European Hematology Association (EHA) in Stockholm, Sweden.
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Transcript
Well, since the frail trial is for now the only trial in this prospective trial in this age group, and especially in this fitness group, one tends to use this as a justification to only use this agent, which I think is fine. We have, as I’ve just said, some impressive data, but I think we still need some more nuance when it comes to that. Obviously, we also report a discontinuation rate of about 30%...
Well, since the frail trial is for now the only trial in this prospective trial in this age group, and especially in this fitness group, one tends to use this as a justification to only use this agent, which I think is fine. We have, as I’ve just said, some impressive data, but I think we still need some more nuance when it comes to that. Obviously, we also report a discontinuation rate of about 30%. We have cardiovascular toxicities, which we might be able to talk about later as well. And so it really comes down to looking at the data, which we now have, looking at some of the real-world analyses, which are also presented here at this year’s ASH, and then really take this information together to find the most appropriate treatment for our patients. But I think what’s really encouraging is to see that there is data enabling us to make an informed decision together with the patients. And this is more and more high-quality data rather than just real-world or post hoc analyses of small patient numbers from larger clinical trials. So I think we have more and more in our arsenal to actually have this discussion with the patients.
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