Obinutuzumab Plus Venetoclax Produces Significant Survival Benefits in CLL

Patients need careful monitoring for side effects

• Obinutuzumab plus the BCL-2 inhibitor, venetoclax, improve progression-free survival in CLL patients
• This combination of therapies has been shown to cause tumor lysis syndrome in an article published in The New England Journal of Medicine
• Patients need to be monitored carefully while on this treatment

For decades, chemotherapy was the foundation of treatment for chronic lymphocytic leukemia (CLL). Today, monoclonal antibodies like obinutuzumab have become part of the standard of care for CLL patients.

Obinutuzumab isn’t particularly effective on its own, so it’s typically combined with other agents, such as a Bruton’s tyrosine kinase (BTK) inhibitor or the BCL-2 inhibitor, venetoclax, to attack CLL cells, says Dr. Julie Vose, chief of hematology/oncology at the University of Nebraska Medical Center. The combination “has been found to be quite effective,” she tells SurvivorNet Connect.

For many patients, obinutuzumab plus venetoclax produces long-lasting remissions. In one NEJM study, 88.2% of CLL patients on this drug combination achieved progression-free survival at 24 months, compared to 64.1% in the group given obinutuzumab plus the chemotherapy drug, chlorambucil.

This treatment combination has been shown to induce tumor lysis syndrome, and therefore patients require close monitoring. The simultaneous death of multiple cancer cells can produce electrolyte disturbances and kidney problems. “Patients often have to be monitored very carefully on these treatments,” Dr. Vose says. “And they sometimes have to be hospitalized for their first treatment.”