In a nutshell
This study looked at the effectiveness of venetoclax (Venclexta) in the treatment of relapsed or unresponsive chronic lymphocytic leukemia (CLL). Researchers found venetoclax improved outcomes in these patients.
CLL is a cancer of the bone marrow. This may lead to an abnormal immune system. It is also often linked with abnormal genes. Medications can be used to target these abnormal genes. They may lose effectiveness over time. Examples include Bruton Tyrosine Kinase inhibitors (BTKi) such as ibrutinib (Imbruvica) and phosphoinositide 3-kinase inhibitor (Pi3Ki) such as idelalisib (Zydelig).
Venetoclax is a drug which may be used when these drugs have failed. It is not yet known if it is effective for these patients.
Methods & findings
105 patients with relapsed or unresponsive CLL were included in the study. All of these patients were treated with venetoclax. 48% had abnormal genes. 60% of patients had previously received a BTKi and 25% had received a Pi3Ki. 10% had received both.
Overall response rate in all patients was 88%. Overall response rate in the BTKi group was 85%. Complete response (complete disappearance of cancer) was seen in 23% of patients on BTKi. In Pi3Ki patients, 92% had a response and 38% had a complete response. Patients who received treatment with both had an 80% response rate and a 20% complete response. 65% of patients survived without the disease worsening after 1-year. Overall survival after 1 year was 75.1%.
Forty-four percent of patients stopped therapy due to side effects. Fifty-four percent of patients stopped due to disease worsening.
The bottom line
The study concluded that venetoclax was effective in patients with CLL that had relapsed or was unresponsive to other treatment.
The fine print
This study is limited by a small sample size and a short follow-up period. Further studies are needed.
Published By :
British Journal of Haematology
Feb 15, 2019