{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T16:23:22Z","timestamp":1788884602115,"version":"build-2803163510"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":55,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"AstraZeneca"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Hematol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Acalabrutinib is a selective, covalent Bruton tyrosine kinase inhibitor approved in multiple countries for patients with chronic lymphocytic leukemia (CLL). Acalabrutinib is approved in China for patients with CLL who received\u2009\u2265\u20091 prior therapy. We report results from a randomized, multicenter, open-label, phase 3 study (NCT04075292) evaluating the efficacy and safety of acalabrutinib vs chlorambucil plus rituximab (C\u2009+\u2009R) in medically unfit patients with treatment-naive CLL in Asia. As of January 3, 2024, 155 patients (overall cohort: acalabrutinib,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200977; C\u2009+\u2009R,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200978; China cohort [mainland China and Taiwan],\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200953 and\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200950, respectively) were enrolled. With a median follow-up of 23.5 and 18.2 months in the overall and China cohorts, respectively, acalabrutinib demonstrated a 92% risk reduction of disease progression or death vs C\u2009+\u2009R (both cohorts: hazard ratio, 0.08;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.0001; primary endpoint). Overall response rates were 76.6% vs 71.8% with median duration of response not reached vs 11.6 months in the acalabrutinib vs C\u2009+\u2009R arms, respectively. In the acalabrutinib arm, no atrial fibrillation or hypertension events were observed. Efficacy and safety were consistent across cohorts. Acalabrutinib was well tolerated and demonstrated a progression-free survival benefit vs C\u2009+\u2009R in this Asian population.\n                  <\/jats:p>","DOI":"10.1007\/s00277-026-07006-z","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T08:54:58Z","timestamp":1779180898000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Acalabrutinib vs chlorambucil plus rituximab in untreated chronic lymphocytic leukemia: A randomized phase 3 Asian study"],"prefix":"10.1007","volume":"105","author":[{"given":"Jia","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuhua","family":"Yi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanh","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjuan","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keshu","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiwen","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Udomsak","family":"Bunworasate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Man","family":"Huynh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su-Peng","family":"Yeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiqiu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofeng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lugui","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"7006_CR1","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.ejim.2018.02.001","volume":"58","author":"B Eichhorst","year":"2018","unstructured":"Eichhorst B, Hallek M, Goede V (2018) Management of unfit elderly patients with chronic lymphocytic leukemia. 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Independent ethics review committees within each institution reviewed and approved the study protocol. All patients provided written informed consent.","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent to publish\/participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Su-Peng Yeh reports consultancy for AbbVie, Amgen, Astellas, AstraZeneca, Bristol Meyers Squibb, BeiGene, Janssen, Novartis, Pfizer, and Takeda. Yiqiu Wang, Xiaofeng Liu, and Wei Fu report employment by AstraZeneca. The remaining authors declare no competing financial interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"327"}}