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Posted by on Dec 31, 2021 in Leukemia | 0 comments

In a nutshell

This study aimed to investigate minimal residual disease (MRD) and long-term outcomes of patients with chronic lymphocytic leukemia (CLL) who were treated with venetoclax (Venclexta) and obinutuzumab (Gazyva). 

This study concluded that this treatment leads to an effective MRD reduction and has good long-term effectiveness.  

Some background

Venetoclax (ven) is a chemotherapy treatment that can be used to treat chronic lymphocytic leukemia (CLL). Obinutuzumab (obi) is a monoclonal antibody (immunotherapy). It can also be used in the treatment of CLL. The combination of ven-obi for one year has been shown to improve outcomes in patients with CLL. 

MRD is the small amount of cancer cells left remaining after treatment. A treatment goal for patients with CLL is negative MRD. This reduces the risk of cancer returning. It is important to evaluate the MRD effectiveness of one-year fixed-duration ven-obi treatment in the long term in patients with CLL. 

Methods & findings

This study involved 432 patients with previously untreated CLL. 216 patients received 12 cycles of venetoclax and 6 cycles of obinutuzumab (ven-obi) and 216 received 12 cycles of chlorambucil (Leukeran) and 6 cycles of obinutuzumab (clb-obi). Patients were treated for one year and were evaluated after being off treatment for the last three years.  

Three months after stopping treatment, 40% of patients in the Ven-Obi group had undetectable MRD levels compared to 7% in the Clb-Obi group. After 29 months, 26.9% in the Ven-Obi group still had undetectable MRD compared to 3.2% in the Clb-Obi group.  

After an average follow-up of 52.4 months, patients in the Ven-Obi group had a 67% lower risk of cancer worsening compared to those in the Clb-Obi group. After 4 years, 74% of the Ven-Obi group were alive without cancer worsening compared to 35.4% for the Clb-Obi group.  

There was no significant difference in overall survival (OS) between the two groups

The bottom line

This study concluded that one-year fixed duration Ven-Obi treatment is effective in MRD reduction and has good long-term outcomes in patients with CLL. 

The fine print

This study was funded by F. Hoffmann-La Roche Ltd and AbbVie Inc, the manufacturers of Ven-Obi.

Published By :

Journal of clinical oncology

Date :

Oct 28, 2021

Original Title :

Minimal Residual Disease Dynamics after Venetoclax-Obinutuzumab Treatment: Extended Off-Treatment Follow-up From the Randomized CLL14 Study.

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