Chronic Lymphocytic Leukemia Coverage from Every Angle

ASH 2020: 5-Year Update From MURANO on Venetoclax Versus Bendamustine in Resistant CLL

By: Vanessa A. Carter, BS
Posted: Wednesday, December 23, 2020

Arnon P. Kater, MD, PhD, of Cancer Center Amsterdam, Netherlands, and colleagues, compared the efficacy of fixed-duration venetoclax/rituximab (VR) with bendamustine/rituximab (BR) in patients with relapsed or refractory chronic lymphocytic leukemia (CLL). A 5-year follow-up of the MURANO study, presented at the 2020 American Society of Hematology (ASH) Annual Meeting and Exposition (Abstract 125), demonstrated undetectable minimal residual disease (MRD) with improved outcomes with the venetoclax combination therapy.

This phase III, randomized trial enrolled a total of 389 individuals with relapsed or refractory CLL. Patients received either 400 mg daily of venetoclax for 2 years plus the standard dose of rituximab for 6 months or 70 mg/m2 of bendamustine with the same rituximab regimen.

The median progression-free survival with VR was 53.6 months, compared with 17.0 months with BR. The 5-year overall survival rate estimates for VR and BR were 82.1% and 62.2%, respectively. Overall survival was improved among patients in the VR group that reached the end of treatment without progressive disease. The 3-year post–end of treatment survival estimates for patients with undetectable MRD and MRD were 95% and 85%, respectively.

Of the participants with undetectable MRD, 32 did not have progressive disease at the end of treatment and remained with undetectable MRD at 5 years. A total of 4 patients had progressive disease, and 47 experienced MRD conversion over a median period of 19.4 months. Progressive disease developed in 19 patients over a median period of 25.2 months. Increased risk of MRD conversion and disease progression correlated with the baseline presence of del(17p), genomic complexity, and unmutated IGVH. All patients with del(17p), 44% of patients with genomic complexity, and 37% of patients with unmutated IGVH experienced MRD conversion with eventual disease progression.

Disclosure: For full disclosures of the study authors, visit

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