Michael Wang, MD, a professor in the Department of Lymphoma and Myeloma at The University of Texas MD Anderson Cancer Center, discusses the promise of venetoclax in the treatment of patients with relapsed/refractory mantle cell lymphoma (MCL).
The field of MCL is rapidly advancing with several new, convenient treatment options, but the relapsed/refractory space remains a huge challenge for research, Wang says. There are currently 2 BTK inhibitors that are FDA-approved in this setting—ibrutinib (Imbruvica) and acalabrutinib (Calquence)—but more therapies are needed. Although venetoclax, a BCL2 inhibitor, has not received FDA approval for use in these patients, it has shown early promise.
In a phase I basket study of patients with B cell lymphoma—MCL, marginal zone lymphoma, follicular lymphoma, and chronic lymphocytic leukemia—venetoclax demonstrated an impressive response rate of 75% in the MCL subgroup. This is important because venetoclax is a convenient, oral agent for which patients do not have to go to clinic. These early data are showing better responses than combination chemotherapy, Wang says.
In addition, there is a phase III study evaluating the use of venetoclax in combination with ibrutinib for patients with relapsed/refractory MCL; data from this study could potentially lead to an FDA approval.