1. In untreated chronic lymphocytic leukemia (CLL) patients with coexisting conditions, patients treated with venetoclax–obinutuzumab experienced greater progression-free survival compared to patients treated with chlorambucil–obinutuzumab.
2. Rates of adverse events in the two treatment groups were similar.
Evidence Rating Level: 1 (Excellent)
Study Rundown: Many patients with CLL are elderly and have clinically relevant comorbid health conditions. The BCL2 antiapoptotic protein is overexpressed in CLL, and venetoclax is an oral BCL2 homology domain 3 mimetic compound which aids to induce apoptosis in B-cells. Whether venetoclax can improve treatment efficacy in CLL patients with comorbidities while limiting toxicity is undetermined. This open-label, phase 3 trial showed progression-free survival is significantly increased in patients taking venetoclax as part of their treatment regimen. Adverse outcomes compared to the current standard treatment regimen were similar.
This study supports the use of venetoclax in CLL patients with comorbidities as it optimizes a key survival outcome while toxicity is comparable with the current treatment standard. The study is limited in its strength to detect a difference in overall survival.