Results of a phase 3 trial were published in the New England Journal of Medicine last month.
Venetoclax is a type of targeted drug called a cell signal blocker. It works by blocking a protein called BCL-2, which helps cancer cells stay alive. Blocking BCL-2 can make lymphoma cells die. It is usually used indefinitely:
- in people with chronic lymphocytic leukaemia (CLL) with specific genetic changes (17p deletion or TP53 mutation) who didn’t respond to or cannot have treatment with ibrutinib or idelalisib
- in people with CLL who didn’t respond to chemo-immunotherapy (chemotherapy with antibody therapy) and ibrutinib/idelalisib
- in combination with rituximab in people with CLL who didn't respond to at least one previous treatment.
The current trial studied fixed-duration venetoclax in combination with the antibody treatment obinutuzumab in people with CLL that had not been treated before who also had other medical conditions. The new treatment combination was compared to standard treatment with chlorambucil and obinutuzumab. In total, 432 people took part in the study.
People treated with venetoclax plus obinutuzumab were more likely to live longer without their lymphoma progressing than people treated with chlorambucil plus obinituzumab. They were also more likely to become ‘minimal residual disease negative’ (MRD negative). This means that CLL could not be detected using genetic analysis of bone marrow or blood samples.
A year after finishing treatment 81% of people who became MRD negative during venetoclax and obinutuzumab treatment were still MRD negative, compared to 27% in the chlorambucil and obinutuzumab. This suggests that the effect is sustained even after the treatment is stopped.
The study authors concluded that fixed-duration venetoclax and obinituzumab can be safely prescribed to people with CLL and other medical conditions, including elderly people. It provided superior outcomes to chlorambucil and obinutuzumab.
To find out more about clinical trials for lymphoma, or to search for a trial that might be suitable for you visit Lymphoma TrialsLink.
22 July 2019