Study: Combination Targeted Therapy Provides Durable Remission for Patients with Chronic Lymphocytic Leukemia

Researchers at The University of Texas MD Anderson Cancer Center found that a combination of ibrutinib (Imbruvica) and venetoclax (Venclexta) provides lasting disease remission in patients with newly diagnosed chronic lymphocytic leukemia (CLL).

The research team previously reported results from this study showing that the ibrutinib and venetoclax combination is effective treating high-risk and older patients with CLL. The updated research offers an additional 2 years of follow-up data and statistics on bone marrow undetectable measurable residual disease (U-MRD) after treatment. Overall, the 3-year progression-free survival was 93%, the 3-year overall survival was 96%, and the response rates were the same for the high-risk subgroup of patients, according to the study.

“CLL is the most common leukemia in the United States and was originally treated with chemoimmunotherapy,” said Nitin Jain, MD, in a press release. “These long-term results show that two years of oral targeted therapy can achieve lasting disease remission for patients with CLL.”

The research team followed 80 previously untreated patients with a median age of 65 years, 92% of whom overall had high-risk genetic anomalies. The median follow-up for all 80 patients was 38.5 months, and the trial participants were 94% white, 4% other, 1% American Indian or Alaska Native, and 1% unknown, according to the study.

Ongoing combined ibrutinib plus venetoclax improved U-MRD responses, according to the study. After 12 cycles of combination therapy, 56% of patients achieved bone marrow U-MRD, whereas after 24 cycles of combination therapy, 66% of patients achieved bone marrow U-MRD remission. Additionally, a total of 75% of patients achieved bone marrow U-MRD remission at any time during the study.

“MRD is one of the most important prognostic markers at the end of leukemia treatment,” Jain said in a press release. “The majority of patients achieved bone marrow MRD remission and no patients on the trial had CLL disease progression.”

Currently, the research team is continuing to monitor the patients’ MRD every 6 months and is working on further correlative studies. The combination therapy is well-tolerated and the toxicity profile of both drugs was consistent with other studies with no additional toxicity observed with the combination, according to press release.

“I think this will be one of several standard of care treatments available for patients with CLL,” Jain said in a press release. “There are pros and cons to each of those approaches, and physicians will have to decide which option is best for their patient.”

REFERENCE

Combination targeted therapy provides durable remission for patients with chronic lymphocytic leukemia. MD Anderson Cancer Center. Published June 10, 2021. Accessed June 14, 2021. https://www.mdanderson.org/newsroom/combination-targeted-therapy-provides-durable-remission-for-patients-with-chronic-lymphocytic-leukemia.h00-159461634.html