Dr. Rule on the Combination of Venetoclax and Ibrutinib in MCL

Simon Rule, MD, PhD, professor of hematology, Plymouth University Medical School, United Kingdom, discusses the combination of venetoclax (Venclexta) and ibrutinib (Imbruvica) in mantle cell lymphoma (MCL).

Only 1 study has been published on the combination of venetoclax and ibrutinib in MCL. Although the study was small, it showed a high complete remission (CR) rate of 63% in a heavily pretreated group of patients, says Rule. Moreover, investigators noted a high rate of minimal residual disease negativity which has enabled some patients to stop therapy.

These are very encouraging data. Now, a phase III trial is planned to evaluate the venetoclax/ibrutinib combination versus ibrutinib alone in the relapsed/refractory setting. Additionally, Rule is currently leading a trial that is looking at the combination of ibrutinib and rituximab (Rituxan) in the frontline setting in elderly patients with the disease. Chemotherapy will serve as the comparator arm of that trial, says Rule. These data will shed light on whether a chemotherapy-free regimen is superior to chemotherapy in the frontline setting. Even if the data do not indicate that the combination is better than chemotherapy, it illustrates the push toward a chemotherapy-free paradigm.