Is Consolidation Therapy for CLL Effective?

Transcript

Jamie Forward:

So, this one is from Larry: What is your view on the efficacy of consolidation therapy?

Dr. William Wierda:

I’ll take it, and maybe, Alessandra, you can add if you would like. I am interested in that strategy. Consolidation in my mind today for patients with CLL would be a strategy that we would add treatment to something that they’re already on that’s been effective at achieving disease control but not necessary a deep remission. We’ve done a couple of trials with that strategy.

And that would be a scenario where patients go a BTK inhibitor, their disease is controlled, they get into a remission but not a deep remission. And Philip Thompson initiated a trial several years ago where we added venetoclax (Venclexta) in that setting as a way to deepen the remission where patients got combined BTK inhibitor plus venetoclax for one to two years, and 70 percent of patients became MRD-undetectable and came off treatment on that study and Dr. Ferrajoli has taken over that study and has updated it more recently. So, I’m a proponent of that strategy.

We can do that with the addition of venetoclax to a BTK inhibitor and the question is are there other strategies that maybe as are more effective than that like the bispecific antibodies or CAR T-cell therapy.

Dr. Alessandra Ferrajoli:

Yeah, I agree. I agree with Dr. Wierda. I mean, we were able to test the addition of venetoclax to a number of patients with ongoing treatment with ibrutinib, acalabrutinib (Calquence), and zanubrutinib (Brukinsa) and so a significant benefit. Right now, the challenge is that as we move more to time-limited therapy, we tend to use multiple agents together upfront so the strategy for the consolidation need to switch more to either cellular therapy or bispecific or maybe other agents that are still in the earlier phase of development.