Alexey V. Danilov, MD, PhD

Alexey V. Danilov, MD, PhD, associate professor of medicine at the Oregon Health & Science University, discusses a treatment regimen of venetoclax (Venclexta) plus rituximab (Rituxan) used for patients with chronic lymphocytic leukemia (CLL) the 2019 American Society of Hematology Annual Meeting.

A long-term follow-up for the phase III MURANO study was presented by John Seymour, MBBS, from the Peter MacCallum Cancer Centre in Australia. This study randomized patients with relapsed or refractory CLL to the combination of venetoclax plus rituximab or bendamustine (Bendeka) plus rituximab (NCT02005471).

Danilov says that it was already known that the study was associated with improved progression-free survival (PFS) and overall survival, as well as a high minimal residual disease rate in the novel therapy arm. In this follow-up, patients had been off of venetoclax and rituximab for 2 years and still showed advantage with the venetoclax regimen. In particular, the PFS rate was about 60% at the time of follow-up whereas almost all of the patients who received bendamustine progressed by this time. There were no new toxicities for these patients.

According to Danilov, patients who received the combination of venetoclax and rituximab responded to subsequent therapy with Bruton tyrosine kinase inhibitors upon progression. However, longer follow-up is necessary to understand the duration of response in these patients.

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Alexey V. Danilov, MD, PhD, discusses a treatment regimen of venetoclax plus rituximab used for patients with chronic lymphocytic leukemia the 2019 American Society of Hematology Annual Meeting.

Follow-Up Shows Venetoclax Plus Rituximab has Long-Term Efficacy in CLL

Alexey V. Danilov, MD, PhD, associate professor of medicine at the Oregon Health & Science University, discusses important studies in the chronic lymphocytic leukemia (CLL) space and questions whether combination or sequential therapy is better for patients with CLL.

Danilov says that in this new era of medicine, chemotherapy will be used less, and now the question at hand is whether patients with CLL can achieve deep responses on regimens with finite durations. At the 2019 American Society of Hematology (ASH) Annual Meeting, studies of ibrutinib (Imbruvica) plus venetoclax (Venclexta), and acalabrutinib (Calquence) plus venetoclax, with or without a CD20 antibody, were exhibited.

The AVO study of acalabrutinib, venetoclax, and obinutuzumab (Gazyva) was presented by Benjamin L. Lampson, MD, PhD, and Matthew S. Davids, MD. It demonstrated good efficacy through high response rates and high durability in patients with CLL. There were a percentage of patients with bone marrow minimal residual disease after 6 months, according to Danilov. Nitin Jain, MD, presented patients with treatment na&iuml;ve CLL who showed high response rates with ibrutinib and venetoclax at ASH.

Danilov wonders if combination therapy is necessary for all patients with CLL or if combination therapy with novel agents can result in prolonged progression-free survival or overall survival compared to single-agent therapy. Longer follow-up is required for combination regimens in clinical trials to determine if physicians should use combination therapy versus sequential therapy.

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Alexey V. Danilov, MD, PhD, discusses important studies in the chronic lymphocytic leukemia space and questions whether combination or sequential therapy is better for patients with chronic lymphocytic leukemia.

Alexey V. Danilov, MD, PhD | Authors

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Follow-Up Shows Venetoclax Plus Rituximab has Long-Term Efficacy in CLL

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