Ibrutinib and venetoclax – pro
Ibrutinib is an oral Bruton’s tyrosine kinase (BTK) inhibitor. The effectiveness and safety of ibrutinib alone or in combination with other treatments had been studied in several B-cell malignancies.
The combination of ibrutinib (Imbruvica) plus venetoclax (Venclexta) produced a complete response (CR) and complete response with incomplete bone marrow recovery (CRi) rate of 56% to treat patients with chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL), according to data presented at the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting. The phase 2 CAPTIVATE study (NCT02910583) found similarly high rates of overall survival (OS) and progression-free survival (PFS) with the combination therapy for patients overall and with high-risk features.
This combination therapy is currently being examined in a complementary older population for the randomized phase 3 GLOW study (NCT03462719).
This regimen is not included in the NCCN guidelines and requires further study
Ghia P, Allan JN, Siddiqi T, et al. Fixed-duration (FD) first-line treatment (tx) with ibrutinib (I) plus venetoclax (V) for chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL): Primary analysis of the FD cohort of the phase 2 captivate study. J Clin Oncol. 2021;39(suppl 15):7502. doi:10.1200/JCO.2021.39.15_suppl.7502
Nitin Jain, M.D., Michael Keating, M.D., Philip Thompson, M.D., Alessandra Ferrajoli, M.D., Jan Burger, M.D., Ph.D., Gautam Borthakur, M.D., Koichi Takahashi, M.D., Zeev Estrov, M.D., Nathan Fowler, M.D., Tapan Kadia, M.D., Marina Konopleva, M.D., Ph.D., Yesid Alvarado, M.D., et al, Ibrutinib and Venetoclax for First-Line Treatment of CLL. N Engl J Med 2019; 380:2095-2103 DOI: 10.1056/NEJMoa1900574
NCCN CLL CSLD-D, 2021