Dr. Rogers on Reducing Risk of Tumor Lysis Syndrome in CLL

Kerry Rogers, MD, assistant professor, Internal Medicine, Division of Hematology, The Ohio State University Comprehensive Cancer Center, discusses reducing the risk of tumor lysis syndrome during the treatment of patients with chronic lymphocytic leukemia (CLL).

The goal of the 2-year, phase Ib/II study was to test the 3 most effective drugs for the treatment of CLL—obinutuzumab (Gazyva), ibrutinib (Imbruvica), and venetoclax (Venclexta). Rogers says these agents work because they each have complimentary mechanisms and nonoverlapping toxicity. For the purposes of the trial, the agents were started sequentially in month-long cycles, 1 per cycle.

Since data show that venetoclax has a risk of tumor lysis syndrome that increases when tumor mutational burden is high, investigators started the venetoclax cycle last to try to maximize disease reduction with the earlier agents. Rogers said investigators focused specifically on disease reduction after the first 2-month period.