Dr. Mead on the Role of BTK Inhibition After Venetoclax in Relapsed/Refractory CLL

Monica D. Mead, MD, a clinical instructor of hematology and oncology at the University of California, Los Angeles (UCLA), discusses the role of BTK inhibition after venetoclax (Venclexta) in relapsed/refractory chronic lymphocytic leukemia (CLL).

During the 2020 ASH Annual Meeting and Exposition, findings from a subanalysis of the phase 3 MURANO trial revealed that patients who relapsed on venetoclax plus rituximab (Rituxan) derived substantial benefit from a subsequent BTK inhibitor or retreatment with a venetoclax-based regimen. As such, investigators concluded that early use of fixed-duration therapy with venetoclax plus rituximab is reasonable and does not compromise subsequent responses to therapy or overall survival in patients with relapsed/refractory CLL.

Up until this research, the success of BTK inhibition post-venetoclax in patients with CLL was unknown, says Mead. Now, evidence suggests that utilizing a venetoclax-based regimen in the second-line setting does not limit the effectiveness of BTK inhibition in the third-line setting, nor does it limit the utility of retreatment with venetoclax because many patients obtained minimal residual disease negativity with retreatment, concludes Mead.