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Posted by on Mar 28, 2021 in Leukemia | 0 comments

In a nutshell

This study aimed to investigate the safety and effectiveness of venetoclax (Venclexta) and low-dose navitoclax (ABT-263) in combination with chemotherapy in patients with relapsed/refractory (r/r) acute lymphoblastic leukemia (ALL). 

This study concluded that this treatment option was well tolerated and showed promissing effectiveness in these patients. 

Some background

Venetoclax is a type of targeted therapy known as a BCL2 inhibitor. It is approved for the treatment of certain types of leukemia. Navitoclax is also a BCL2 inhibitor. It is an experimental treatment and can be dose-limited due to the side effect of thrombocytopenia (low level of platelets). 

It was unknown if venetoclax and low-dose navitoclax could be combined with chemotherapy to provide a safe and effective treatment for patients with r/r ALL.

Methods & findings

This study involved 47 patients with r/r ALL or lymphoblastic lymphoma (LL). Patients had an average of 4 prior treatments. All patients were treated with navitoclaxvenetoclax, and chemotherapy. 

The complete remission (CR) rate was 60%. The CR rate was 75% in pediatric patients. Undetected minimal residual disease MRD was seen in 34% of all patients and 57% of pediatric patients. MRD is a small number of cancer cells left after treatment that can lead to relapse. 28% of patients proceeded to transplantation or CAR T-cell therapy. 

The most common side effects were low levels of white blood cells with fever, diarrhea, nausea (46.8% each), low levels of potassium (44.7%), and abdominal pain (42.6%). 78.7% of patients experienced serious side effects including low white blood cells with fever and generalized infection.

The bottom line

This study concluded that venetoclax and navitoclax with chemotherapy combination was well tolerated and had a promising effectiveness in patients with r/r ALL.  

The fine print

This study had a very small number of participants. Further, larger studies are needed to evaluate this combination in patients with r/r ALL.

Published By :

Cancer discovery

Date :

Feb 16, 2021

Original Title :

Venetoclax and Navitoclax in Combination with Chemotherapy in Patients with Relapsed or Refractory Acute Lymphoblastic Leukemia and Lymphoblastic Lymphoma.

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