Dr. Phillips on the Toxicity Profile of Venetoclax/Lenalidomide/Rituximab in MCL

Tycel Jovelle Phillips, MD, clinical associate professor, Division of Hematology and Oncology, Department of Internal Medicine, Rogel Cancer Center, Michigan Medicine, discusses the toxicity profile of the combination of venetoclax (Venclexta), lenalidomide (Revlimid), and rituximab (Rituxan) in mantle cell lymphoma (MCL).

Interim results of a phase 1 study (NCT03523975), which were presented during the 2021 ASCO Annual Meeting, demonstrated a high overall response rate and minimal residual disease–negativity rate with the combination of venetoclax, lenalidomide, and rituximab in patients with newly diagnosed MCL.

Regarding safety, grade 3 or higher neutropenia was observed in 68% of patients and grade 3 or higher thrombocytopenia was observed in 50% of patients, which was slightly higher than anticipated, explains Phillips. Although the etiology of the toxicities is not fully understood, multiple patients who experience thrombocytopenia discontinued venetoclax, Phillips says.

Similarly, most dose reductions and modifications were attributed to venetoclax-related toxicities, Phillips says. Despite this, the addition of venetoclax appeared to have deepened responses and shortened time to response in this patient population, he adds.

Pending positive mature data, the combination may offer a frontline, time-limited, cost-effective treatment option to patients with MCL, concludes Phillips.