In a nutshell
This study aimed to investigate the effectiveness of venetoclax (Venclexta) and rituximab (Rituxan) treatment in patients with relapsed/refractory chronic lymphocytic leukemia.
This study concluded that venetoclax-rituximab treatment was effective for these patients.
Chronic lymphocytic leukemia (CLL) can be treated using different methods. Venetoclax works to enable the death of cancerous cells in CLL patients. Rituximab is a monoclonal antibody that targets CLL cells for destruction. Bendamustine (Treanda) is a chemotherapy used for CLL.
Relapsed/refractory CLL (RR CLL) is harder to treat. Relapsed CLL occurs when the treatment provided works initially and then CLL returns. Refractory CLL occurs when the treatment does not work.
The efficiency of venetoclax in combination with rituximab in patients with RR CLL was unknown.
Methods & findings
This study involved 389 patients with RR CLL. One group received venetoclax for up to 2 years and rituximab for the first 6 months (VR group). Another group received bendamustine and rituximab for 6 months (BR group). Progression-free survival (PFS, time from treatment until disease progression) was measured. Patients were follwed for an average of 23.8 months.
16.5% of the VR group experienced events of progression or death compared to 58.5% in the BR group. The 2-year PFS rate was 84.9% for the VR group compared to 36.3% for the BR group.
The 17p chromosome deletion has an impact on CLL prognosis and is a high-risk marker. The 2-year PFS for 17p deletion patients was 81.5% in VR group compared to 27.8% in BR group. The 2-year PFS for those without 17p deletion was 85.9% in VR group compared to 41.0% in BR group.
The VR group had a higher rate of neutropenia (low levels of white blood cells) when compared to BR group. The rates febrile neutropenia (neutropenia with a fever) and infections/infestations were lower in the VR group when compared to the BR group.
The bottom line
This study concluded that PFS rates were significantly higher in CLL patients treated with VR when compared to those treated with BR.
The fine print
This study was funded by AbbVie and Genentech, the manufacturers of venetoclax. Genentech is also a manufacturer of rituximab.
Published By :
The New England Journal of Medicine
Mar 22, 2018