Considerations with Retreatment of Venetoclax-Containing Regimens

EP: 1.Clinical Perspectives: 59yF with R/R CLL after Time-Limited Therapy

EP: 2.Timing of Treatment Initiation in Relapsed CLL: Factoring in Prognostic and Patient Factors

EP: 3.Expert Perspectives: Sequencing Strategies after Acalabrutinib + Venetoclax +/- Obinutuzumab as First-Line Therapy in CLL

EP: 4.Clinical Perspectives: 59yF with R/R CLL Experiencing BTKi Treatment-Related AE

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EP: 5.Considerations with Retreatment of Venetoclax-Containing Regimens

EP: 6.Identifying BTKi Treatment Intolerance in R/R CLL

EP: 7.Clinical Approaches in Switching Between BTKi’s in R/R CLL & Practical Considerations for Drug Holidays

EP: 8.Expert Insights on BRUIN CLL-321: Pirtobrutinib in BTKi Pretreated CLL Patients

Venetoclax Retreatment Strategies and Continuous Therapy

This segment examines the appropriateness of venetoclax retreatment in patients who previously achieved deep remissions but developed BTK inhibitor intolerance. With a three-year remission and achievement of MRD negativity, the patient doesn't clearly meet criteria for venetoclax-refractory disease, making retreatment a reasonable consideration.

The discussion weighs the benefits of time-limited venetoclax therapy versus continuous BTK inhibitor approaches for high-risk disease. While venetoclax retreatment may be effective, many experts favor continuous BTK inhibition for patients with newly acquired high-risk genomic features due to the drugs' ability to suppress proliferation of high-risk clones.

Available data from studies like Murano provide some evidence supporting venetoclax retreatment strategies, though the median progression-free survival of 24 months in retreatment scenarios suggests limitations. Real-world experience and ongoing studies like the REVENGE trial are providing additional insights into optimal retreatment approaches, with patient-specific factors ultimately guiding individual treatment decisions.