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Comparison of Venetoclax-Based Treatments for Patients With Relapsed/Refractory Chronic Lymphocytic Leukemia: A
Benjamin Heyman1, Michael Choi2, Thomas J Kipps3
1Division of Regenerative Medicine Department of Medicine UC San Diego Moores Cancer Center UC San Diego La Jolla California USA.
Introduction:
The optimal venetoclax-based treatment for patients with relapsed/refractory (R/R) CLL is still unknown, especially for high-risk patients.
Methods:
We performed a retrospective analysis of 98 patients with R/R CLL treated with venetoclax-based regimens. Patients received venetoclax alone or in combination with rituximab (VenR), obinutuzumab (VenO), or a BTKi (primarily ibrutinib).
Results:
Combination groups achieved higher complete remission (CR) and uMRD rates: VenO (CR 68%, uMRD 86%), VenR (CR 63%, uMRD 82%), Ven + BTKi (CR 43%, uMRD 70%), versus monotherapy (CR 51%, uMRD 67%). At a median 52-month follow-up, median PFS was superior in combination arms (76.6 months) compared to monotherapy (58.9 months, p = 0.04).
Conclusion:
This analysis validates, in a real-world academic cohort, that venetoclax-based combination therapy, particularly with obinutuzumab or BTKi, yields higher rates of deep remission and superior PFS compared to monotherapy for R/R CLL.
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