Acalabrutinib, as a BTK inhibitor, should be scheduled according to the indications and individual patient conditions. It is usually administered continuously until disease progression or intolerable toxicity occurs.

1. Chronic lymphocytic leukemia/small lymphocytic lymphoma

(1) Standard protocol: Take 100mg orally twice a day.

(2) Course characteristics: Continuous treatment until disease progression or unacceptable toxicity.

(3) Combination therapy: When used in combination with atezolizumab, attention should be paid to the order of administration.

2 sets of cell lymphoma

(1) Single drug treatment: The same regimen is used twice a day, 100mg each time.

(2) Treatment cycle: There is no fixed number of treatment courses, and the efficacy needs to be evaluated regularly.

(3) Special adjustment: In case of grade 3 or above adverse reactions, suspension or reduction is required.

3 Principles for adjusting treatment courses

(1) Dose adjustment: Classify and handle according to the severity of adverse reactions.

(2) Suspension criteria: Treatment should be interrupted when specific hematological toxicity occurs.

(3) Termination indicator: Discontinue medication when disease progression or inability to tolerate toxicity occurs.

4 Clinical efficacy

(1) Chronic lymphocytic leukemia: The overall response rate of newly treated patients treated with monotherapy is 85%, and the median progression free survival has not been achieved, demonstrating a long-lasting therapeutic effect.

(2) Mantle cell lymphoma: The objective response rate for recurrent/refractory patients is 81%, with a complete response rate of 40%, and the median duration of efficacy is 22.3 months.

5 Security Advantages

(1) Less adverse reactions: Compared to the first generation BTK inhibitors, the incidence of bleeding events and atrial fibrillation in acatinib is significantly reduced.

(2) High selectivity: Lower off target effects on targets such as EGFR/ITK, reducing related side effects.

6. Timing of Efficacy Evaluation

(1) Initial assessment: Perform the first imaging examination 2-4 months after the start of treatment.

(2) Follow up frequency: Evaluate treatment response every 3-6 months.

(3) Long term monitoring: Even if the condition is stable, continuous medication and follow-up are necessary.