Dr. Arora on the Use of Venetoclax in CLL

Shagun Arora, MD, assistant clinical professor at the University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, discusses the use of venetoclax (Venclexta) in the treatment of patients with chronic lymphocytic leukemia (CLL).

Venetoclax is currently approved by the FDA for use in the relapsed/refractory setting in patients with 17p deletions and in those without the abnormality, says Arora. The agent is likely to move to the frontline setting, although it has yet to receive an indication for upfront use, she adds.

The BCL-2 inhibitor has shown efficacy when used after other kinase inhibitors and is most likely efficacious before their use as well. However, physicians are unsure of whether or not the kinase inhibitors would show activity after ibrutinib (Imbruvica) if it is moved to the frontline setting, says Shah. Therefore, the standard of care in patients with relapsed/refractory disease is to reserve venetoclax for a later line of therapy following ibrutinib. If a physician does decide to prescribe venetoclax, it should be given in conjunction with rituximab (Rituxan), she concludes.