Ibrutinib and Venetoclax for First-Line Treatment of CLL

Authors: Nitin Jain, Michael J. Keating, Philip A. Thompson, Alessandra Ferrajoli, Jan A. Burger, Gautam Borthakur, Koichi Takahashi, Zeev Estrov, Nathan Fowler, Tapan M. Kadia, Marina Konopleva, Yesid Alvarado, Musa Yılmaz, Courtney D. DiNardo, Prithviraj Bose, Maro Ohanian, Naveen Pemmaraju, Elias Jabbour, Koji Sasaki, Rashmi Kanagal‐Shamanna, Keyur P. Patel, Jeffrey L. Jorgensen, Naveen Garg, Xuemei Wang, Katrina Sondermann, Nichole Cruz, Chongjuan Wei, Ana Ayala, William Plunkett, Hagop M. Kantarjian, Varsha Gandhi, William G. Wierda - New England Journal of Medicine, NEJM 2019 cited by 504

BACKGROUND: Ibrutinib, an inhibitor of Bruton's tyrosine kinase, and venetoclax, an inhibitor of B-cell lymphoma 2 protein, have been approved for patients with chronic lymphocytic leukemia (CLL). Preclinical investigations have indicated potential synergistic interaction of their combination. METHODS: ). RESULTS: aberration, or chromosome 11q deletion. With combined treatment, the proportions of patients who had complete remission (with or without normal blood count recovery) and remission with undetectable minimal residual disease increased over time. After 12 cycles of combined treatment, 88% of the patients had complete remission or complete remission with incomplete count recovery, and 61% had remission with undetectable minimal residual disease. Responses were noted in older adults and across all high-risk subgroups. Three patients had laboratory evidence of tumor lysis syndrome. The adverse-event profile was similar to what has been reported with ibrutinib and venetoclax. CONCLUSIONS: In this study, combined venetoclax and ibrutinib was an effective oral regimen for high-risk and older patients with CLL. (Funded by AbbVie and others; ClinicalTrials.gov number, NCT02756897.).