Dr. Constantine S. Tam on BCL2 Inhibitors Compared to Ibrutinib, Idelalisib

Constantine S. Tam, MD, Consultant Hematologist, Division of Hematology and Oncology, Peter MacCallum Cancer Center, Melbourne, Australia discusses BCL2 inhibitors in chronic lymphocytic leukemia (CLL).

BCL2 inhibitors are very active in CLL. One challenge is selecting between BCL2 inhibitors and agents like Ibrutinib and idelalisib, said Tam.

Ibrutinib and idelalisib are very effective in most patients, but rarely achieve complete remission. The BCL2 inhibitor venetoclax, especially in combination with rituximab, regularly allow patients to achieve complete remission and minimal residual disease, said Tam.

A major factor in choosing one class over the over is the intention for treatment. If an oncologist wants a low-side effect therapy that will be given over a long period of time, ibrutinib and idelalisib are the ideal. If they are looking to eventually stop therapy all together a BCL2 inhibitors is the best option.

There are also combination studies combining ibrutinib with venetoclax, which may have potential.