Good News! BTK inhibitor therapy is effective in patients with CLL resistant to venetoclax

[Jm954]

3rd April 2020 Blood

Key points to note:

BTK inhibitor therapy achieves durable disease control for patients with CLL after progression on venetoclax.

Prior remission duration ≥24 months and deep response on venetoclax are associated with longer PFS on subsequent BTKi therapy.

Prior remission duration ≥24 months and attainment of complete remission or undetectable measurable residual disease on venetoclax were associated with longer PFS after BTKi salvage.

More here: ashpublications.org/blood/a...

Stay home, stay safe

Jackie

[cartwheels]

I think i read that btk inhibitors like ibrutinib can offen revive patients who are becoming resistant to veneticlax somehow stimulating the drug

[Jm954 Administrator in reply to cartwheels]

Mmmmm, if so, that would be good. Have you got a reference?

[cartwheels in reply to Jm954]

I'm sure I read it on here or on the cll society run by Dr Hoffman

[ChrisLovesLife]

I've often wondered what could happen next since I'm down to 100 mg of Venetoclax daily due to tolerance/side effect issues after 14 months. I appreciate the information! Be well!

[AdrianUK]

Thanks for sharing this which I didn't notice a month ago so maybe others will also see. Brian K recorded an interview about this piece of work when it was presented. Here is the video and it is encouraging that even in really heavily pre-treated patients (i.e. people who historically had loads of rounds of treatment with chemotherapy before the modern drugs were available) they were still able to be treated with venetoclax and even after that more than half showed a response to ibrutinib.

The question remains open which way round is going to be best and this video honestly addresses that. We simply do not know which will give an over all longer time before we need another medicine: taking Ibrutinib for a few years then going onto venetoclax or taking venetoclax first before then going onto ibrutinib only when repeated bursts of a year or two of Venetoclax combination no longer get a deep remission.

One option is to see venetoclax a bit like a modern variant of FCR in terms of its goal of treatment. I.e. there surely has to be a chance that some folks who take venetoclax in combination early in the disease and get to MRD undetectable are going to turn out to have such long remissions they are effectively cured. Certainly some patients with FCR experience just that. Anyway the video is only 4 minutes so it might well be of interest for others to watch: youtube.com/watch?v=UcVbcAX...(Not working as expected?)