Venetoclax 17p patient

[Cgr2018]

Just a question, I read an article of a profesionals about Venetoclax responses, and it says that for young patients with 17p with cll than relapsed to ibutrinib with a progression of the diasease, Ventoclax don’t responde well and you need a stem narrow transplant as theraphy.

Could anyone know something about it or say something about it?

Thank you so much, indeed

[AussieNeil Administrator]

Could you please share that reference? Knowing the trial, context and authors would really help.

Neil

[Cgr2018 in reply to AussieNeil]

professionalabstracts.com/d...

Thank you!

[AussieNeil Administrator in reply to Cgr2018]

I note that on foilennium (slide) 5 - and duplicated in slide 6, when discussing relapsed CLL, TP53 dysfunction -> Ibrutinib or Venetoclax +R * or Venetoclax or Idelalisib + R *

Consider allo SCT in fit.

However, I think the text you are referring to is this on slide 25

Allogeneic SCT is still a valid option for fit CLL patients with very-high-risk disease or refractory to BCR-I, who are unlikly to have longterm benefit from a bcl2-inhibitor." (i.e. Venetoclax)

So don't rule out stem cell transplants when you have fit, relapsed patients that have first failed Idelalisib. Note that per slide 24, this is based on 36 patients, (with a) median 3 previous therapies (10 ibrutinib).

Neil

[Cgr2018 in reply to AussieNeil]

Thank you for your response. As I read in sooo many studies, Venetoclax is a really effective for 17p Tp53 cll patients who relapsed with Ibutrinib, I mean resistant to it during the treatment...So I very upset when I read this conclussion in the study I attached to you. For this reason I share with you this presentation, to help me if you have any information about Ventoclax in young patients that I don’t know. I think It could be very effective in most of cases who relapsed to ibutrinib with 17p TP53, and will achive on them a remission again. Thats correct? Thank you!

[Nicebaps]

An interesting article. I've been on mono Venetoclax since Aug 17 (400mg per day) and although at the start it was doing it's job that is now not the case. I'm now slowly relapsing and so the next treatment will be Ibrutunib with a view of undergoing Stem Cell Replacement soon. I was meant to start Ibrutunib back in March but the C19 reared itself and the world went into meltdown. I will be continueing V for the time being but the main concern now is if my count continues to rise that could trigger my ITP and that would not be good at all.

Fingers crossed ...

[Cgr2018 in reply to Nicebaps]

I send to you all of my power and luck. My brother it’s on Ibutrinib since July 2018, his labs tests are great with it, the cll was pretty well under control. But know dónde his lasts blood test on 4th of July, one small node in the neck appears, and I’m very anxius and upset most of time, thinking there is no other solution to fix this problem. But I pray all the time for his cll doesn’t relapsed, but if it’s returnud, Ventoclax could pretty help him a lot with great results. I hope you can anserwer if Ventoclax mono therapy is a very effective therapy, for your own and other experience. Of course, for you there are other treatments, Ibutrinib is a miracle for my brother, but now I’m really sad about the relapsing. Im pretty sure everything it’s going to be great with your ibutrinib treatment, trust me.

Lots of love!!!!

[prbild]

Here are some additional articles on the effectiveness of venetoclax

Real-world outcomes and management strategies for venetoclax-treated chronic lymphocytic leukemia patients in the United States

haematologica.org/content/1...

Clinicopathological features and outcomes of progression of CLL on the BCL2 inhibitor venetoclax

bloodjournal.org/content/12...

I am 17p deleted and went on to venetoclax monotherapy after progressing on ibrutinib. It was very effective for a while, but eventually began to fail. I was fortunate enough to enroll in a clinical trial for CAR T and am currently in remission. Encouraging results are being seen with venetoclax +obinutuzumab, so stay hopeful. Anything that holds off the disease while new treatments are developed is a good thing.

[Cgr2018 in reply to prbild]

Thank you so much! How long did have you been on Ventoclax treatment? As I read, 17p patients after Ibutrinib progressing could have long and deeper responses, MRD negative in a great number,...? I mean better results than Imbruvica sometimes for this 17p patients..

Thank you so much indeed!

[prbild in reply to Cgr2018]

I was on ibrutinib for about 3.5 years and venetoclax for 1.5 years. The venetoclax was still working, but becoming ineffective. As my hematologist says, everyone is different, so I can't say this is the rule.

[Cgr2018 in reply to prbild]

Thank you! Because why was still working but becoming ineffective? Don’t understand if it was working..

Thank you for your support indeed!!

[prbild in reply to Cgr2018]

While not yet at a critical level, the ALC (WBC*% Lymph) was rising at an increasing rate. Eventually the venetoclax would stop working. It was better to transfer to another therapy before that happened.

[Cgr2018 in reply to prbild]

Thank you!

Best Regards!

[Canuck901 in reply to Cgr2018]

17 p del is a wildcard and unpredictable apparently. Some Drs say it’s good to treat with Venetoclax early , I don’t know .

There isn’t enough data out there yet of what MRD means