Hematologic Oncology Update, Issue 1, 2016 (Video Program)Use of the newly FDA-approved Bcl-2 inhibitor venetoclax in CLL
1:48 minutes.
TRANSCRIPTION:
DR LEONARD: So venetoclax is a Bcl-2 inhibitor. It’s kind of a second-generation Bcl-2 inhibitor. And the concept is that Bcl-2 plays a significant role in CLL cells and their ability to stay alive. And so it’s an oral agent. Its main toxicity and the main challenge with it, at least so far, is the issue of tumor lysis that came up with earlier patients on the initial trials with CLL but now I think has been very carefully worked out. I think the issue is really following very carefully the recommended dosing schedule and, in many of the studies, the concept of debulking, so that you minimize the tumor lysis risk that’s come up. And I think so far it’s going smoothly. We’ll see how it goes as more patients are treated. DR LOVE: Maybe you can summarize a little bit about, in general, what we know about venetoclax in CLL both as a single agent and in combination. DR LEONARD: Most of the data have been in relapsed patients as a single agent. And the response rates have been relatively high. Most people are responding. I think the summary is that the treatment regimen is influenced by the tumor lysis syndrome risk. I think that’s getting worked out. Certainly in relapsed patients that’s less of a concern, because they have fewer options. Obviously, you need to watch for it. I think when we start looking at up-front regimens, if you have to admit patients to the hospital to get it, some patients are going to be less excited about that in general. So we’ll see. It’s still early days. But I think most likely that what the future’s going to hold, I think, are combinations. And we’re starting to see them with different chemotherapy regimens with obinutuzumab and in other settings. |