Venclexta Superior to Treanda When Combined with Rituxan in CLL

American Society Hematology Meeting update continues to show superiority of Venclexta for Chronic Lymphocytic Leukemia

by Dr. C.H. Weaver M.D. updated 12/2018

Venclexta (venetoclax) plus Rituxan (rituximab) significantly reduces the risk of cancer progression or death at three years, compared with Treanda (bendustamine) plus Rituxan in the treatment of chronic lymphocytic leukemia that has recurred following prior therapies. These results were updated at the 60th annual meeting of the American Society of Hematology (ASH).

About Chronic Leukemia

Chronic lymphocytic leukemia (CLL) is a type of cancer that starts in immune cells called B-cells. It is the most common adult leukemia with over 15,000 individuals diagnosed annually in the United States and almost 5,000 patients succumb to the condition. CLL is not a rapidly growing cancer, but the cancerous cells accumulate in blood, bone marrow, lymph nodes and spleen, resulting in enlargement of these organs and decreased bone marrow blood cell production and immune function. CLL interferes with the normal production of antibodies and immunoglobulins, so the body cannot properly fight infections.

Although CLL may respond to therapy, it is considered an incurable disease, as most patients will experience a return of their cancer. There are several different treatment options available for CLL, and researchers continue to evaluate the effectiveness of these different treatment strategies to determine optimal therapeutic approaches for each patient.

Doctors have reported the results of the MURANO clinical trial which directly compare two different treatment regimens in patients with CLL that had recurred following prior therapies. Overall 389 patients with CLL who were divided into two groups. One group was treated with a standard treatment consisting of Treanda (bendustamine) plus Rituxan (rituximab), and the other group was treated with a newer regimen consisting of Venetoclax plus Rituxan.

Venetoclax was already approved by the United States Food and Drug Administration (FDA) for the treatment of recurrent CLL with a 17 p deletion. However, its approval was based on results that measured anti-cancer responses, and the FDA has required follow-up data to include duration of responses and survival rates.

The results of the MURANO trial reported at a median follow-up time of nearly 36 months after the initiation of treatment demonstrated that the combination of Ventoclax+Rituxan represented a “profound improvement” compared to the standard Treanda+Rituxan treatment.

  • Updated 3 year overall survival rates are 88% among the group of patients treated with Venetoclax+Rituxan compared with only 79% of those treated with Treanda+Rituxan.
  • Survival without cancer progression is 71.4% for patients treated with Venetoclax compared with 15.2 percent for those treated with Treanda+Rituxan.
  • Overall survival was improved by approximately 50% with Venetoclax+Rituxancompared to Treanda+Rituxan.
  • The Venetoclax+Rituxan combination was generally well tolerated.
  • The researchers concluded longer follow-up of data from the MURANO trial will continue to help determine the true effectiveness of Venetoclax+Rituxan combination therapy for CLL patients.

References:

  1. Seymour J, Kipps T, Eichhorst B, et al. Venetoclax plus rituximab is superior to bendamustine plus rituximab in patients with relapsed/refractory chronic lymphocytic leukemia – results from pre-planned interim analysis of the randomized phase 3 Murano study. 59th annual meeting of the American Society of Hematology. Late-breaking abstract #2. Available at: . Accessed February 26, 2018.
  2. Seymour J, et al. MURANO trial establishes feasibility of time-limited venetoclax-rituximab (VenR) combination therapy in relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL). Presented at the 2018 American Society of Hematology Annual Meeting & Exposition: December 1, 2018; San Diego.

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