Chronic Lymphocytic Leukemia Coverage from Every Angle

Ibrutinib and Venetoclax in Treatment of Resistant CLL

By: Anna Nowogrodzki
Posted: Friday, January 10, 2020

Ibrutinib and venetoclax combination therapy is effective and tolerated in patients with relapsed or refractory chronic lymphocytic leukemia (CLL), according to recent results from the relapsed or refractory cohort of a phase II trial. Nitin Jain, MD, of The University of Texas MD Anderson Cancer Center, Houston, presented this research on behalf of his colleagues at the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 359).

“Combined venetoclax and ibrutinib is an effective, well-tolerated, chemotherapy-free oral regimen for patients with relapsed/refractory CLL,” the authors wrote.

The study cohort included 80 patients with relapsed or refractory CLL. Patients received ibrutinib daily for 3 cycles, after which venetoclax was added for 24 cycles of combination therapy. One patient was excluded from analysis because their cancer was reclassified as splenic marginal zone lymphoma, and five patients discontinued therapy before venetoclax was introduced, leaving 74 patients who received combination therapy. The median age of patients was 61.5 years, and the median follow-up was 22.3 months.

After 12 cycles of combination therapy, 29 of the 60 patients (48%) achieved minimal residual disease remission. A total of 24 patients received 24 cycles of combination therapy. Of these 24 patients, 16 (67%) achieved minimal residual disease remission. Of these 16, all but 1 had reached minimal residual disease remission by 18 cycles. Two patients’ leukemia progressed after finishing 24 cycles of combination therapy.

Grade 3 or 4 neutropenia occurred in 29% of patients; atrial fibrillation, in 9% of patients; and grade 3 or 4 thrombocytopenia, in 3% of patients. One patient developed Hodgkin’s transformation, one developed myelodysplastic syndrome, and one developed severe cytopenias. Two patients died of infectious complications during the ibrutinib monotherapy phase of the study.

Disclosure: The study authors’ disclosure information may be found at

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