Dr. Seymour Discusses Rationale for MURANO Study in CLL

John F. Seymour, MBBS, PhD, clinical hematologist, associate director of Clinical Research, Peter MacCallum Centre, director of the integrated Haematology Department of the Peter MacCallum Cancer Centre and the Royal Melbourne Hospital, discusses the rationale for the MURANO study in patients with chronic lymphocytic leukemia (CLL).

Novel agents have shown promise in this space, particularly venetoclax, a BCL2 inhibitor, says Seymour, but also BTK inhibitors and PI3 kinase inhibitors. The challenge with these drugs as single agents is that they have to be given continuously until disease progression. This is because the complete remission rate and minimal residual disease (MRD) negativity is relatively low. In order to bring patients off therapy, physicians need to see MRD negativity.

The combination of venetoclax and rituximab (Rituxan) has been known to achieve MRD negativity, so the MURANO trial tested this against the standard 6 cycles of bendamustine and rituximab in a time-limited fashion for patients with relapsed/refractory CLL. In updated data presented at the 2018 ASH Annual Meeting, patients treated with venetoclax had higher progression-free survival and MRD negativity rates.