MRD on 200 mg venetoclax (venclexta)

[profrich]

I asked before whether anyone was on 200 mg of venetoclax, and a number of people said yes (due to side effects).

I am now wondering whether anyone on 200 mg achieved MRD negative status.

[Ontheblock4m]

Big unanswered question is whether long term outcomes are better with max dose vs lower doses I do not believe the answer is known. Most gurus push max dose and treat side effects mostly neutropenia a thrombocytopenia as needed while real world docs lower dose to maintain reasonable levels of neutrophils a platelets

[profrich in reply to Ontheblock4m]

I agree completely with you. That big question is if 200 mg (or less) brings ALC down to less than 1, are you improving things by taking more, and getting neutropenia?

An interesting study would be to let neutrophils and lymphocytes guide the decision of whether to bump up. That is, strive to keep neutrophils above 1.5 and lymphocytes in normal range, and see if outcomes are as good as striving to get to 400 mg.

[pkpayne]

I am on 200 mg of Ventoclax and I'm MRD. I'm also on 280 mg of Ibrutinib along with Ventoclax. But I started off being on 400 of Venetoclax and double of Ibrutinib and after about a year they cut me back because of some minor side effects. I'm still MRD.

Paula

[Buzzjacket]

I was on venetoclax and ibrutinib on clinical trial and got to MRD negative in marrow and blood after one year. I started v on 400 mg and when neutrophils dropped below 1.0 they gave me neupogen. I did not think the constant neupogen shots were a good idea and did not want neulasta. So at six month mark we cut back to 300 mg and I still got to MRD negative with neutrophils slightly above 1.0. I had to push to cut back to 300 because clinical trial protocol was strict, but doctor supported me.