Evaluating venetoclax with BR for the treatment of relapsed or refractory non-Hodgkin’s lymphoma

This study evaluated the safety and effectiveness of venetoclax (Venclexta) plus BR (bendamustine, rituximab) in patients with relapsed or refractory (does not respond to treatment) non-Hodgkin’s lymphoma (NHL). This study concluded that this treatment was tolerated and showed promising effectiveness in these patients.

The BR regimen is a commonly used treatment in patients with relapsed or refractory NHL. 41 – 90% of patients respond to BR. However, many tumors become resistant (no longer respond to treatment). BR has been combined with other agents to improve patient outcomes. Venetoclax is a targeted therapy. This type of treatment blocks cancer cell survival. This leads to cancer cell death. Venetoclax has already been approved for a type of leukemia (cancer of the blood and bone marrow). Whether combining BR with venetoclax is effective in patients with relapsed or refractory NHL remains under investigation.

This study involved 60 patients with relapsed or refractory NHL. 53% of these had follicular lymphoma, 37% had diffuse large B-cell lymphoma, and 10% had marginal zone B-cell lymphoma. Half of patients (52%) had refractory disease. All patients received venetoclax plus BR for an average of 5.5 months.

Overall, 65% of patients responded to treatment. 30% of patients had disappearance of all signs of cancer (complete response). 35% of patients had a partial response (tumor shrinkage). The average progression-free survival (time from treatment until disease progression) was 10.7 months. The average duration of overall response (time from response to treatment until disease progression) was 38.3 months.

Side effects were reported by 98% of participants. The most common side effects were nausea (70%), low white blood cell count (68%), diarrhea (55%), and low platelet count (cells involved in blood clotting; 52%). 83% of patients reported severe to life-threatening side effects. These included low white blood cell count (60%) and low lymphocyte count (38%). 8% of patients also reported low white blood cell count with fever.

80% of patients stopped venetoclax treatment. Of these, 29.2% stopped treatment due to side effects.

This study concluded that venetoclax plus BR was tolerated and effective in patients with relapsed or refractory non-Hodgkin’s lymphoma.

This study received funding support from AbbVie and Genentech, the developers of venetoclax. Both companies also participated in this study’s design and data analysis.

This was a phase 1 study. Future studies are needed in order to establish the role of venetoclax plus BR for the treatment of relapsed or refractory non-Hodgkin’s lymphoma.