In positive interim analysis results from the phase 3 trial ECHO, acalabrutinib (Calquence; AstraZeneca) in combination with standard of care chemoimmunotherapy—bendamustine and rituximab—demonstrated both statistically significant and clinically meaningful improvement in progression-free survival (PFS) in adult patients with previously untreated mantle cell lymphoma (MCL) compared with standard of care alone. Acalabrutinib is a next-generation, selective inhibitor of Bruton tyrosine kinase (BTK) that binds covalently to BTK to hinder its activity. BTK signaling results in the activation of pathways that are necessary for B-cell proliferation, trafficking, chemotaxis, an adhesion within B cells.