Venetoclax: a review in relapsed/refractory chronic lymphocytic leukemia

2019-10-02T17:37:11Z (GMT) by Lesley J. Scott

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Disclosure: The preparation of this review was not supported by any external funding.

Conflicts of interest: Lesley Scott is a salaried employees of Adis/Springer, is responsible for the article content and declares no relevant conflicts of interest.


Additional information about this Adis Drug Evaluation can be found here


Abstract

Venetoclax (Venclyxto®; Venclexta®) is a first-in-class, oral, selective B-cell lymphoma-2 (BCL-2) inhibitor. The drug is approved in numerous countries, including those of the EU and in the USA, for the treatment of adults with relapsed or refractory (RR) chronic lymphocytic leukemia (CLL); the specific indication(s) for venetoclax may vary between individual countries. Venetoclax monotherapy or combination therapy with rituximab was an effective treatment, provided durable responses, and had a manageable safety profile in pivotal clinical trials in adults with RR CLL, including in patients with adverse prognostic factors. In combination with 6 cycles of rituximab, venetoclax (fixed 24 months’ treatment) was more effective than bendamustine plus rituximab (6 cycles) in prolonging progression-free survival (PFS) and inducing undetectable minimal residual disease (uMRD) in peripheral blood (PB) and bone marrow (BM), with these benefits sustained during 36 months’ follow-up. Hence, with its novel mechanism of action and convenient oral once-daily regimen, venetoclax monotherapy or fixed 24-month combination therapy with rituximab represents an important option for treating RR CLL, including in patients with del(17p) or TP53 mutation and those failing a B cell receptor (BCR) inhibitor and/or chemotherapy.

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