Broader Measures of Treatment Success & Venetoclax Retreatment

This segment broadens the evaluative lens beyond traditional endpoints such as progression-free survival and overall response rate. The panel discusses alternative metrics that increasingly guide CLL therapy decisions, including time to next treatment, treatment tolerability, real-world durability, and overall survival, an endpoint often difficult to interpret given extended patient lifespans and numerous subsequent therapies.

Clinicians note that time to next treatment is particularly relevant in relapsed settings, where maintaining quality of life and delaying further lines of therapy may be just as important as achieving deep remissions. They explain that although imaging-based assessments may show early progression, many patients can still derive meaningful benefit from continuing therapy, emphasizing the need for individualized clinical judgment.

The panel then transitions to venetoclax retreatment, a growing area of interest. They discuss real-world and clinical trial data demonstrating that venetoclax re-exposure can be effective, although durability may be shorter than with first exposure. The MURANO trial subset analyzing retreatment is highlighted, showing a median progression-free survival of approximately two years, encouraging but tempered by the observation that many patients progressed while still on therapy. They reference additional real-world data suggesting venetoclax-based therapies can still perform well even after prior use, though prospective evidence remains limited.

Treatment success in CLL is multidimensional. Balancing depth and duration of response, quality of life, safety, and future treatment optionality is central to optimizing long-term patient outcomes.