A Study to Evaluate Relative Bioavailability, Proton Pump Inhibitor (PPI) (Rabeprazole) Effect, Food Effect and Particle Size Effect of New Acalabrutinib Tablet in Healthy Subjects

Bioavailability Clinical Trial

Official title:

A 2-Part, Phase I, Open-label, Single-Dose, Sequential Randomized Crossover Study of New Acalabrutinib Tablet in Healthy Subjects to Evaluate Relative Bioavailability, Proton Pump Inhibitor (Rabeprazole) Effect, Food Effect and Particle Size Effect

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04488016
• Other study ID #: D8220C00018
• Status: Completed
• Phase: Phase 1
• Start date: June 24, 2020
• Est. completion date: January 20, 2021

Study information

• Verified date: February 2021
• Source: AstraZeneca
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study will be a 2-part, open-label, single-center relative bioavailability, PPI effect, food-effect and particle size effect randomized crossover study of acalabrutinib tablets in healthy subjects (males or females). The study will be divided in 2 study parts; following a review of the safety and Pharmacokinetics (PK) data from Part 1, the study is planned to be continued with Part 2.

Description:

The study will be divided in 2 study parts; Part 1 of this study will be an open-label, 3-treatment-period, 4-treatment, single-center relative bioavailability, PPI effect, and food-effect randomized crossover study of a new acalabrutinib tablet in healthy subjects (males or females).

The relative bioavailability part of Study Part 1 is designed to investigate the PK of the acalabrutinib tablet compared with the PK of acalabrutinib capsule, when administered as a single dose with water under the fasted condition (>10 hours). The PPI effect part of Study Part 1 is designed to compare the PK of acalabrutinib tablet with or without coadministration of the PPI rabeprazole. The food-effect part of Study Part 1 is designed to compare the PK of acalabrutinib tablet under fed and fasted conditions. For each subject, a SmartPill will be administered with 120 mL of still water followed immediately by a single oral dose of acalabrutinib tablet (Treatment B, C or D) or acalabrutinib capsule (Treatment A) administered with 120 mL of still water.

Study Part 1 will comprise:

• A screening period of maximum 28 days;

• Three treatment periods during which subjects will be resident from prior to the evening meal the night before dosing with Investigational medicinal product (IMP) (Day -1) until at least 48 hours after dosing; discharged on the morning of Day 3; and

• A Follow-up Visit within 7 to 10 days. There will be a minimum washout period of at least 7 days between each acalabrutinib administration.

A decision to continue with Study Part 2 will be made following a review of the preliminary data for relative bioavailability (acalabrutinib tablet versus acalabrutinib capsule), food effect, PPI effect, and safety observed in Part 1.

Part 2 of this study will be an open-label, 4-treatment-period, 4-treatment, single-center relative bioavailability, randomized crossover study to determine the effect of particle size on the PK of a single dose of acalabrutinib tablet in healthy subjects (males or females).

This relative bioavailability study is designed to investigate the PK of acalabrutinib tablets with various drug substance particle size distributions and the PK of acalabrutinib solution at a single oral dose of 100 mg under the fasted condition (>10 hours).

Study Part 2 will comprise:

• A screening period of maximum 28 days;

• Four treatment periods during which subjects will be resident prior to the evening meal the night before dosing with IMP (Day -1) until at least 48 hours after dosing; discharged on the morning of Day 3; and

• A Follow-up Visit within 7 to 10 days. There will be a minimum washout period of at least 3 days between each acalabrutinib administration.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 54
• Est. completion date: January 20, 2021
• Est. primary completion date: January 20, 2021
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 55 Years

Eligibility

Inclusion Criteria:

1. Provision of signed and dated, written informed consent prior to any study specific procedures.

2. Healthy adult male or female subjects aged 18 - 55 years with suitable veins for cannulation or repeated venipuncture.

3. Male subject must adhere to the contraception methods.

4. Females must have a negative pregnancy test at screening and on admission to the unit, must not be lactating and must be of non-childbearing potential, confirmed at screening.

5. Have a Body mass index (BMI) between 18.5 and 30 kg/m2 inclusive and weigh at least 50 kg and no more than 100 kg inclusive at screening.

6. Understands the study procedures in the Informed Consent Form (ICF) and willing and able to comply with the protocol.

7. Willingness and ability to swallow study drugs, including the SmartPill.

8. Willingness to consume a standardized, high- calorie, high-fat FDA breakfast.

Exclusion Criteria:

1. History of any clinically significant disease or disorder which, in the opinion of the Principal Investigator (PI), may either put the volunteer at risk because of participation in the study, or influence the results or the volunteer's ability to participate in the study.

2. History or presence of gastrointestinal (GI), hepatic or renal disease, or any other condition known to interfere with absorption, distribution, metabolism, or excretion of drugs.

3. Evidence of ongoing systemic bacterial, fungal, or viral infection (including upper respiratory tract infections).

4. Any clinically significant illness, medical/surgical procedure, or trauma within 30 days of the first administration of IMP.

5. Any clinically significant abnormalities in clinical chemistry, hematology, coagulation, or urinalysis results, at screening and first admission to the study unit (first treatment period) as judged by the PI, and defined as: (1) Serum Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), alkaline phosphatase (ALP), and serum bilirubin (total and direct)

> Upper limit of normal (ULN). (2) Hemoglobin < ULN.

6. Any clinically significant abnormal findings in vital signs at screening and first admission to the study unit (first treatment period), as judged by the PI.

7. Any clinically significant abnormalities on 12-lead ECG at screening and first admission to the study unit (first treatment period), as judged by the PI.

8. Any positive result on screening for serum hepatitis B surface antigen, hepatitis B core antibody (anti-HBc), hepatitis C antibody, and HIV antibody.

9. Known or suspected history of drug abuse, as judged by the PI.

10. Has received another new chemical entity (defined as a compound which has not been approved for marketing) within 90 days of the first administration of IMP in this study.

The period of exclusion begins 90 days after the final dose or 30 days after the last visitwhichever is the longest.

11. Plasma donation within 30 days of screening or any blood donation/loss more than 500 mL during the 90 days prior to screening.

12. History of severe allergy/hypersensitivity or ongoing allergy/hypersensitivity, as judged by the PI or history of hypersensitivity to drugs with a similar chemical structure or class to acalabrutinib or rabeprazole.

13. Current smokers or those who have smoked or used nicotine products (including e-cigarettes) within the 90 days prior to screening.

14. Positive screen for drugs of abuse or cotinine at screening or on each admission to the study center or positive screen for alcohol on each admission to the study center.

15. Use of drugs with enzyme-inducing properties such as St John's Wort within 3 weeks prior to the first administration of IMP.

16. Use of any prescribed or non-prescribed medication including antacids, analgesics (other than paracetamol/acetaminophen), herbal remedies, megadose vitamins (intake of 20 to 600 times the recommended daily dose) and minerals during the 2 weeks prior to the first administration of IMP or longer if the medication has a long half-life. Hormone replacement therapy will not be allowed.

17. Known or suspected history of alcohol or drug abuse or excessive intake of alcohol as judged by the PI.

18. Excessive intake of caffeine-containing drinks or food (e.g., coffee, tea, chocolate) as judged by the PI. Excessive intake of caffeine defined as the regular consumption of more than 600 mg of caffeine per day (e.g., >5 cups of coffee) or would likely be unable to refrain from the use of caffeine-containing beverages during confinement at the investigational site.

19. Part 1 only: Inability or unwillingness to swallow SmartPill, including:

Subject has any of the following contraindications for the SmartPill:

1. A history of gastric bezoars

2. Swallowing disorders

3. Suspected or known strictures, fistulas or physiological/mechanical GI obstruction

4. History of GI surgery within 90 days of administration

5. Severe dysphagia to food or pills

6. Crohn's disease or diverticulitis

7. Cardiac pacemakers or other implanted electromedical devices 20 Involvement of any AstraZeneca, Acerta Pharma, Parexel or study site employee or their close relatives. 21 Subjects who have previously received acalabrutinib. 22 Judgment by the PI that the subject should not participate in the study if they have any ongoing or recent (i.e., during the screening period) minor medical complaints that may interfere with the interpretation of study data or are considered unlikely to comply with study procedures, restrictions, and requirements. 23 Subjects who cannot communicate reliably with the Investigator. 24 Vulnerable subjects, e.g., kept in detention, protected adults under guardianship, trusteeship, or committed to an institution by governmental or juridical order.

Related Conditions & MeSH terms

• B-cell Lymphoid Cancer
• Bioavailability

Intervention

Drug:
• Treatment A- Part 1
Subjects will receive 100 mg acalabrutinib capsule, fasted state;
• Treatment B- Part 1
Subjects will receive 100 mg acalabrutinib tablet (Variant 1), fasted state
• Treatment C - Part 1
Subjects will receive 100 mg acalabrutinib tablet (Variant 1), fed state
• Treatment D- Part 1
Subjects will receive Rabeprazole 20 mg QD (fasted) at 2 hours before administration of 100 mg acalabrutinib tablet (Variant 1) and following prior administration of rabeprazole 20 mg Twice per day (BID) (with meals) on Days -3, -2 and -1.
• Treatment A-Part 2
Subjects will receive 100 mg acalabrutinib tablet (Variant 1), fasted state
• Treatment B - Part 2
Subjects will receive 100 mg acalabrutinib tablet (Variant 2), fasted state
• Treatment C - Part 2
Subjects will receive 100 mg acalabrutinib tablet (Variant 3), fasted state
• Treatment D - Part 2
Subjects will receive 100 mg acalabrutinib solution, (Variant 4), fasted state

Locations

Country	Name	City	State
United States	Research Site	Baltimore	Maryland

Sponsors (2)

Lead Sponsor	Collaborator
AstraZeneca	Acerta Pharma, LLC

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Maximum observed plasma concentration (Cmax)-Acalabrutinib	Part 1: To assess the relative bioavailability of the acalabrutinib tablet compared with acalabrutinib capsules in fasted state.; Part 2: To assess the impact of drug substance particle size on the bioavailability of acalabrutinib tablets.	Day 1 and Day 2
Primary	Area under the plasma concentration-time curve from time zero to time of last quantifiable concentration (AUClast)-Acalabrutinib	Part 1: To assess the relative bioavailability of the acalabrutinib tablet compared with acalabrutinib capsules in fasted state.; Part 2: To assess the impact of drug substance particle size on the bioavailability of acalabrutinib tablets.	Day 1 and Day 2
Primary	Area under plasma concentration-time curve from time zero to infinity (AUCinf)-Acalabrutinib	Part 1: To assess the relative bioavailability of the acalabrutinib tablet compared with acalabrutinib capsules in fasted state.; Part 2: To assess the impact of drug substance particle size on the bioavailability of acalabrutinib tablets.	Day 1 and Day 2
Secondary	Cmax -ACP-5862	Part 1: To assess the ACP-5862 PK profile of the acalabrutinib tablet compared with acalabrutinib capsule in fasted state.; Part 2: To assess the impact of drug substance particle size on the ACP-5862 PK profile of acalabrutinib tablets.	Day 1 and Day 2
Secondary	AUClast-ACP-5862	Part 1: To assess the ACP-5862 PK profile of the acalabrutinib tablet compared with acalabrutinib capsule in fasted state.; Part 2: To assess the impact of drug substance particle size on the ACP-5862 PK profile of acalabrutinib tablets.	Day 1 and Day 2
Secondary	AUCinf-ACP-5862	Part 1: To assess the ACP-5862 PK profile of the acalabrutinib tablet compared with acalabrutinib capsule in fasted state.; Part 2: To assess the impact of drug substance particle size on the ACP-5862 PK profile of acalabrutinib tablets.	Day 1 and Day 2
Secondary	Area under the plasma concentration-time curve from time zero to 12 hours post-dose (AUC0-12) - Acalabrutinib and ACP-5862	Part 1: To evaluate the effects of proton pump inhibitor rabeprazole on acalabrutinib and its metabolite (ACP-5862) PK profiles obtained after dosing the acalabrutinib tablet; To evaluate the effect of food on acalabrutinib and its metabolite (ACP-5862) PK obtained after dosing the acalabrutinib tablet.; Part 2: To compare PK of acalabrutinib tablet versus acalabrutinib oral solution in healthy subjects.	Day 1 and Day 2
Secondary	AUClast- Acalabrutinib and ACP-5862	Part 1: To evaluate the effects of proton pump inhibitor rabeprazole on acalabrutinib and its metabolite (ACP-5862) PK profiles obtained after dosing the acalabrutinib tablet; To evaluate the effect of food on acalabrutinib and its metabolite (ACP-5862) PK obtained after dosing the acalabrutinib tablet.; Part 2: To compare PK of acalabrutinib tablet versus acalabrutinib oral solution in healthy subjects.	Day 1 and Day 2
Secondary	AUCinf- Acalabrutinib and ACP-5862	Part 1: To evaluate the effects of proton pump inhibitor rabeprazole on acalabrutinib and its metabolite (ACP-5862) PK profiles obtained after dosing the acalabrutinib tablet; To evaluate the effect of food on acalabrutinib and its metabolite (ACP-5862) PK obtained after dosing the acalabrutinib tablet.; Part 2: To compare PK of acalabrutinib tablet versus acalabrutinib oral solution in healthy subjects.	Day 1 and Day 2
Secondary	Extrapolated area under the curve from tlast to infinity, expressed as percentage of AUCinf (%AUCextrap)- Acalabrutinib and ACP-5862	Part 1: To evaluate the effects of proton pump inhibitor rabeprazole on acalabrutinib and its metabolite (ACP-5862) PK profiles obtained after dosing the acalabrutinib tablet; To evaluate the effect of food on acalabrutinib and its metabolite (ACP-5862) PK obtained after dosing the acalabrutinib tablet.; Part 2: To compare PK of acalabrutinib tablet versus acalabrutinib oral solution in healthy subjects.	Day 1 and Day 2
Secondary	Cmax- Acalabrutinib and ACP-5862	Part 1: To evaluate the effects of proton pump inhibitor rabeprazole on acalabrutinib and its metabolite (ACP-5862) PK profiles obtained after dosing the acalabrutinib tablet; To evaluate the effect of food on acalabrutinib and its metabolite (ACP-5862) PK obtained after dosing the acalabrutinib tablet.; Part 2: To compare PK of acalabrutinib tablet versus acalabrutinib oral solution in healthy subjects.	Day 1 and Day 2
Secondary	Half-life associated with terminal slope of a semi-logarithmic concentration-time Curve (t½)- Acalabrutinib and ACP-5862	Part 1: To evaluate the effects of proton pump inhibitor rabeprazole on acalabrutinib and its metabolite (ACP-5862) PK profiles obtained after dosing the acalabrutinib tablet; To evaluate the effect of food on acalabrutinib and its metabolite (ACP-5862) PK obtained after dosing the acalabrutinib tablet.; Part 2: To compare PK of acalabrutinib tablet versus acalabrutinib oral solution in healthy subjects.	Day 1 and Day 2
Secondary	Time to reach maximum observed concentration (tmax)- Acalabrutinib and ACP-5862	Part 1: To evaluate the effects of proton pump inhibitor rabeprazole on acalabrutinib and its metabolite (ACP-5862) PK profiles obtained after dosing the acalabrutinib tablet; To evaluate the effect of food on acalabrutinib and its metabolite (ACP-5862) PK obtained after dosing the acalabrutinib tablet.; Part 2: To compare PK of acalabrutinib tablet versus acalabrutinib oral solution in healthy subjects.	Day 1 and Day 2
Secondary	Terminal elimination rate constant (Kel)- Acalabrutinib and ACP-5862	Part 1: To evaluate the effects of proton pump inhibitor rabeprazole on acalabrutinib and its metabolite (ACP-5862) PK profiles obtained after dosing the acalabrutinib tablet; To evaluate the effect of food on acalabrutinib and its metabolite (ACP-5862) PK obtained after dosing the acalabrutinib tablet.; Part 2: To compare PK of acalabrutinib tablet versus acalabrutinib oral solution in healthy subjects.	Day 1 and Day 2
Secondary	Relative bioavailability (Frel)- Acalabrutinib and ACP-5862	Part 1: To evaluate the effects of proton pump inhibitor rabeprazole on acalabrutinib and its metabolite (ACP-5862) PK profiles obtained after dosing the acalabrutinib tablet; To evaluate the effect of food on acalabrutinib and its metabolite (ACP-5862) PK obtained after dosing the acalabrutinib tablet.; Part 2: To compare PK of acalabrutinib tablet versus acalabrutinib oral solution in healthy subjects.	Day 1 and Day 2
Secondary	Apparent total body clearance of drug from plasma after extravascular administration (CL/F)- Acalabrutinib and ACP-5862	Part 1: To evaluate the effects of proton pump inhibitor rabeprazole on acalabrutinib and its metabolite (ACP-5862) PK profiles obtained after dosing the acalabrutinib tablet; To evaluate the effect of food on acalabrutinib and its metabolite (ACP-5862) PK obtained after dosing the acalabrutinib tablet.; Part 2: To compare PK of acalabrutinib tablet versus acalabrutinib oral solution in healthy subjects.	Day 1 and Day 2
Secondary	Apparent volume of distribution during the terminal phase after extravascular Administration (Vz/F)- Acalabrutinib and ACP-5862	Part 1: To evaluate the effects of proton pump inhibitor rabeprazole on acalabrutinib and its metabolite (ACP-5862) PK profiles obtained after dosing the acalabrutinib tablet; To evaluate the effect of food on acalabrutinib and its metabolite (ACP-5862) PK obtained after dosing the acalabrutinib tablet.; Part 2: To compare PK of acalabrutinib tablet versus acalabrutinib oral solution in healthy subjects.	Day 1 and Day 2
Secondary	ACP-5862 (metabolite) to acalabrutinib (parent) ratio (M/P) for Cmax- Acalabrutinib and ACP-5862	Part 1: To evaluate the effects of proton pump inhibitor rabeprazole on acalabrutinib and its metabolite (ACP-5862) PK profiles obtained after dosing the acalabrutinib tablet; To evaluate the effect of food on acalabrutinib and its metabolite (ACP-5862) PK obtained after dosing the acalabrutinib tablet.; Part 2: To compare PK of acalabrutinib tablet versus acalabrutinib oral solution in healthy subjects.	Day 1 and Day 2
Secondary	ACP-5862 (metabolite) to acalabrutinib (parent) ratio (M/P) for AUClast- Acalabrutinib and ACP-5862	Part 1: To evaluate the effects of proton pump inhibitor rabeprazole on acalabrutinib and its metabolite (ACP-5862) PK profiles obtained after dosing the acalabrutinib tablet; To evaluate the effect of food on acalabrutinib and its metabolite (ACP-5862) PK obtained after dosing the acalabrutinib tablet.; Part 2: To compare PK of acalabrutinib tablet versus acalabrutinib oral solution in healthy subjects.	Day 1 and Day 2
Secondary	ACP-5862 (metabolite) to acalabrutinib (parent) ratio (M/P) for AUCinf- Acalabrutinib and ACP-5862	Part 1: To evaluate the effects of proton pump inhibitor rabeprazole on acalabrutinib and its metabolite (ACP-5862) PK profiles obtained after dosing the acalabrutinib tablet; To evaluate the effect of food on acalabrutinib and its metabolite (ACP-5862) PK obtained after dosing the acalabrutinib tablet.; Part 2: To compare PK of acalabrutinib tablet versus acalabrutinib oral solution in healthy subjects.	Day 1 and Day 2
Secondary	Number of subjects with adverse events	Number of subjects reporting at least one event and number of events where appropriate	From Screening to follow-up visit (7 to 10 days after last dose)
Secondary	Number of subjects with abnormal systolic and diastolic blood pressure	Abnormal values in systolic and diastolic blood pressure.	At screening (Day -28), Day -1, and Day 2
Secondary	Number of subjects with abnormal pulse rate	Abnormal values in pulse rate.	At screening (Day -28), Day -1, and Day 2
Secondary	Number of subjects with abnormal respiratory rate	Abnormal values in respiratory rate.	At screening (Day -28), Day -1, and Day 2
Secondary	Number of subjects with abnormal body temperature	Abnormal values of body temperature.	At screening (Day -28), Day -1, and Day 2
Secondary	Number of subjects with abnormal electrocardiogram (12-lead ECG)	Prolongation of the QTc interval.	At screening (Day -28), Day -1, and Day 2
Secondary	Number of subjects with abnormal physical examination	Abnormal values in physical examination	At screening (Day -28), Day -1, and Day 2
Secondary	Number of subjects with abnormal hematology -Cell count	To assess white blood cell count and red blood cell count.	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Number of subjects with abnormal electrolytes	To assess abnormal serum level of sodium and potassium.	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Number of subjects with abnormal hemoglobin (Hb)	Abnormal values of hemoglobin	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Number of subjects with abnormal hematocrit	Abnormal values of hematocrit.	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Number of subjects with abnormal mean corpuscular volume (MCV)	Abnormal values of MCV	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Number of subjects with abnormal mean corpuscular hemoglobin (MCH)	Abnormal values of MCH	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Number of subjects with abnormal mean corpuscular hemoglobin concentration (MCHC)	Abnormal values of MCHC	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Number of subjects with abnormal clinical chemistry	The laboratory variables to be measured are: bilirubin.	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Incidence of abnormal urinalysis	The laboratory variables to be measured are: protein in urine. Microscopy (if positive for protein): Casts (Cellular, Granular, Hyaline).	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Number of subjects with abnormal glucose (fasting)	Abnormal values of glucose (fasting)	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Number of subjects with abnormal C-reactive protein (CRP)	Abnormal values of CRP.	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Number of subjects with abnormal blood urea nitrogen (BUN)	Abnormal values of BUN	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Number of subjects with abnormal thyroid-stimulating hormone (TSH)	Abnormal values of TSH	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Number of subjects with abnormal T4	Abnormal values of T4	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Number of subjects with abnormal hematology- Differential count	To assess neutrophils absolute count, lymphocytes absolute count, monocytes absolute count, eosinophils absolute count, basophils absolute count, platelets, and reticulocytes absolute count.	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Percentage of subjects with adverse events	Percentage of subjects reporting at least one event and number of events where appropriate	From Screening to follow-up visit (7 to 10 days after last dose)
Secondary	Number of subjects with abnormal electrolytes	To assess abnormal serum level of calcium.	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Number of subjects with abnormal electrolytes	To assess abnormal serum level of phosphate.	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Number of subjects with abnormal clinical chemistry	The laboratory variables to be measured are: alkaline phosphatase (ALP), alanine aminotransferase (ALT), and aspartate aminotransferase (AST).	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Number of subjects with abnormal clinical chemistry	The laboratory variables to be measured are: creatinine.	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Number of subjects with abnormal clinical chemistry	The laboratory variables to be measured are: albumin.	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Number of subjects with abnormal clinical chemistry	The laboratory variables to be measured are: cystatin C.	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Number of subjects with abnormal clinical chemistry	The laboratory variables to be measured are: gamma glutamyl transpeptidase.	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Number of subjects with abnormal clinical chemistry	The laboratory variables to be measured are: urea and uric acid.	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Incidence of abnormal urinalysis	The laboratory variables to be measured are: glucose in urine.	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Incidence of abnormal urinalysis	The laboratory variables to be measured are: blood in urine. Microscopy (if positive blood): RBC, WBC.	At screening (Day -28), Day-1, Day 1, Day 2, and Follow-up visit (7-10 days after last dose)
Secondary	Taste	The taste of the acalabrutinib oral solution (Treatment D) will be assessed by a taste and smell questionnaire after the administration of the IMP. Subjects will be asked to complete the questionnaire themselves which will rate questions on the taste of the IMP (sweet, salty, sour, bitter, metallic, hot/spicy, overall taste of the medicine) from 0 to 10 (where 0 is extremely bad and 10 is extremely nice).	Day 1
Secondary	Smell	The smell of the acalabrutinib oral solution (Treatment D) will be assessed by a taste and smell questionnaire after the administration of the IMP. Subjects will be asked to complete the questionnaire themselves which will rate questions on the smell of the IMP (extremely bad to extremely nice, whether subjects would take it again) of the medicine) from 0 to 10 (where 0 is extremely bad and 10 is extremely nice).	Day 1