Dr. Roeker on the Rationale for BTK/Venetoclax Combos in CLL

Lindsey Roeker, MD, hematologic oncologist, Memorial Sloan Kettering Cancer Center, discusses the rationale for combining venetoclax (Venclexta) with BTK inhibitors for use in patients with chronic lymphocytic leukemia (CLL).

Because CLL cells are B cells that have undergone changes to their genetic code, they do things that other B cells would not do. For example, CLL cells make copies of themselves and do not die after a normal lifespan, according Roeker. However, the combination of BTK inhibitors, which are cytostatic, and venetoclax, which is cytotoxic, allows for the targeting of both mechanisms of proliferation and survival of CLL , Roeker says. 

Additionally, BTK inhibitors and venetoclax are effective in different ways, Roeker adds. BTK inhibitors appear to be more effective in targeting nodal disease, whereas venetoclax is effective in targeting peripheral disease. By combining these therapies together, CLL cells can be driven out of the lymph nodes and eliminated in the peripheral blood, Roeker concludes.