Venetoclax Works After BTK Inhibitors in Chronic Lymphocytic Leukemia

An international real-world study shows that the BCL2 inhibitor venetoclax was effective in patients with chronic lymphocytic leukemia (CLL) who had tried and discontinued Bruton tyrosine kinase (BTK) inhibitor treatment.

Data for the study were drawn from the CLL Collaborative Study of Real-World Evidence (CORE), which involved 23 centers. Results were presented at the 65th ASH Annual Meeting and Exposition by Nilanjan Ghosh, MD, PhD, of the Levine Cancer Institute/Atrium Health in Charlotte, North Carolina, and colleagues.

Venetoclax is a BCL2 inhibitor that is approved by the U.S. Food and Drug Administration for treatment of adults with CLL or small lymphocytic lymphoma (SLL). Researchers said they performed the study because although there are a lot of data for venetoclax in newly diagnosed and relapsed or refractory CLL, they saw a gap in evidence when it came to how the drug works after treatment with covalent BTK inhibitors. In 2,020 CORE patients, 184 discontinued covalent BTK therapy and started on venetoclax-based treatment, either monotherapy or in combination with CD20-targeted monoclonal antibodies (rituximab or obinutuzumab).

The overall response rate was 78%, with median progression-free survival of 43.2 months. Venetoclax was also effective in second-line and third-line treatment after covalent BTK inhibitor therapy (see TABLE).

The results may provide some reassurance to physicians who want to practice evidence-based medicine in the changing CLL treatment landscape, with multiple treatment options available.

cBTKi, covalent Bruton’s tyrosine kinase inhibitor.

Reference

Ghosh N, Lamanna N, Eyre TA, et al. Treatment effectiveness with venetoclax-based therapy after Bruton tyrosine kinase inhibitors in chronic lymphocytic leukemia: an international real-world study. Abstract #1908. Presented at the 65th ASH Annual Meeting and Exposition; December 9-12; San Diego, California.