Physician Views Preview: Digging into the impressive US launch of AstraZeneca's Calquence

AstraZeneca is making quite a habit of successful new cancer drug launches. Its latest, the BTK inhibitor Calquence, has not disappointed. Initially approved in the US for the treatment of mantle cell lymphoma (MCL) back in 2017, Calquence was subsequently approved in the larger indication of chronic lymphocytic leukaemia (CLL) in late 2019.

Over the course of 2020, sales of Calquence have continued to grow strongly as a result of its use in CLL, reaching $511 million in the US market. This is impressive given the entrenched position of the multi-billion dollar Imbruvica franchise (marketed by AbbVie and Johnson & Johnson), more so considering that Calquence is now being used to treat more than four in every 10 newly diagnosed CLL patients who start therapy with a BTK inhibitor.

Looking ahead, these dynamics may evolve in the favour of Calquence. AstraZeneca recently announced top-line data from a head-to-head study evaluating Calquence against Imbruvica, showing that the two drugs are equally efficacious in terms of progression-free survival benefit and that Calquence is associated with a statistically significant lower incidence of atrial fibrillation compared to Imbruvica.

In light of these results, we are fielding a short survey to US-based oncologists and haematologists who specialise in the treatment of CLL to better understand which factors are driving the utilisation of Calquence. Specifically we are asking…

Q. Do you routinely treat or specialise in the treatment of chronic lymphocytic leukaemia (CLL)?


Yes – routinely

Yes – specialise

No [Screen out]


Q. Which of the following statements applies to your own experience with the CLL therapy Calquence (acalabrutinib)?

[Single select]

I currently use this drug

I have used this drug previously and would consider using it again

I have used this drug previously but no longer consider it

I have never used this drug but would consider using it

I have never used this drug and would not consider it

I am not aware of this drug


Q. Which of the following clinical factors have motivated you (or would motivate you) to prescribe Calquence for the treatment of CLL?

[Multiple choice]

Slows progression of disease

Provides long-term efficacy

Provides long-term safety

A positive risk-benefit profile

Positively impacts quality of life

It has few side effects

Allows for good patient compliance

It has convenient administration

Is cost effective

Has novel mechanism of action


Q. Which of the following non-clinical factors have motivated you (or would motivate you) to prescribe Calquence for the treatment of CLL?

[Multiple choice]


Formulary access

Co-pay assistance

Guideline recommendation

Medical affairs support

Sales representative support

Other (please state)


Q. Preliminary data from the Phase III head-to-head ELEVATE-RR study evaluating Calquence versus Imbruvica (ibrutinib) in high-risk CLL patients was recently announced showing that Calquence demonstrated non-inferior progression-free survival benefit and statistically significantly lower incidence of atrial fibrillation compared to patients treated with Imbruvica.

Further hierarchical testing revealed no difference for Grade 3 or higher infections or Richter's transformation. There was a descriptive trend for numerically favourable overall survival. Full data will be presented at a future medical meeting.

Based on these preliminary data, do you expect results from the ELEVATE-RR study to have any impact on your future utilisation of Calquence at the expense of Imbruvica?

0 – No impact    1            2            3            4            5            6            7            8            9              10 – Significant impact


Results and related analysis will shortly be published for FirstWord Pharma PLUS subscribers to read, with the opportunity for non-FirstWord Pharma PLUS subscribers to purchase these findings. To be notified when poll results and analysis become available, please click here

As always, FirstWord would very much like to receive your feedback and suggestions. Note: FirstWord Polls are powered by Medefield MedePolls, a fast-turnaround service to conduct instant polls of up to five questions with guaranteed samples that include physicians from dozens of specialties and over 100 markets. To conduct this poll with a different audience, or an entirely different poll, contact us at

To read more Physician Views articles, click here.