, updated progression-free survival (PFS) data from the CLL14 study continued to show an improved PFS with venetoclax (Venclexta) plus obinutuzumab (Gazyva) versus chlorambucil plus obinutuzumab in patients with treatment-naïve CLL. 

After completing treatment, patients will have continual MRD monitoring through a longitudinal analysis, says Al-Sawaf. ​According to the analysis presented at 2020 ASCO Virtual Scientific Program, 47.2% of patients had ​undetectable MRD 18 months after completing venetoclax/obinutuzumab versus ​7.4% who received chlorambucil/obinutuzumab.

Ultimately, these data show that half of patients lose undetectable MRD ​after stopping treatment while the other half are able to maintain MRD negativity approximately 2 years ​after stopping treatment, Al-Sawaf concludes.

Videos

Othman Al-Sawaf, MD, discusses ongoing minimal residual disease  assessment for patients in the phase 3 CLL14 study with chronic lymphocytic leukemia.

Dr. Al-Sawaf on Continual MRD Assessment ​After Venetoclax/Obinutuzumab in CLL

Othman Al-Sawaf, MD, a physician with the University Hospital of Cologne in Germany, discusses benefits of a fixed duration treatment versus continuous treatment in chronic lymphocytic leukemia (CLL).

Traditionally, patients with CLL have been treated with fixed-duration treatments, says Al-Sawaf. When chemoimmunotherapy was administered to patients, they usually received 6 cycles of treatment. As such, for approximately 6 months, patients would have to regularly visit the hospital for surgery, chemoimmunotherapy, or antibody infusions. However, most of the novel compounds that are emerging have been developed for continuous treatment that the patient can receive orally and until disease progression or unacceptable toxicity. 

Therefore, the field started to move away from fixed-duration approaches to more tolerable, but continuously administered drugs, adds Al-Sawaf. Now, however, there has been a shift back to examining whether these novel compounds can be administered as a fixed-duration rather than continuous treatment, concludes Al-Sawaf.

Othman Al-Sawaf, MD, discusses benefits of a fixed duration treatment versus continuous treatment in chronic lymphocytic leukemia.

Dr. Al-Sawaf on Fixed-Duration Versus Continuous Treatment in CLL

Othman Al-Sawaf, MD, physician, University Hospital of Cologne, Cologne, Germany, discusses updated data from the phase 3 CLL14 trial in chronic lymphocytic leukemia (CLL).

The multicenter, open-label, randomized CLL14 trial enrolled patients with previously untreated CLL. Patients were randomized to either venetoclax (Venclexta) plus obinutuzumab (Gazyva) or chlorambucil plus obinutuzumab.

The first main finding from the study presented at the 

 was that there was a sustained and significant progression-free survival (PFS) benefit for patients treated with venetoclax plus obinutuzumab, says Al-Sawaf. With 3 year follow-up, results showed a PFS rate of 81.9% in patients treated with venetoclax plus obinutuzumab versus 49.5% in patients treated with chlorambucil plus obinutuzumab.

 aberrations and unmutated IGHV status saw a benefit with venetoclax plus obinutuzumab, but the benefit with the combination was higher in patients with mutated 

 status, Al-Sawaf adds. The difference observed in the primary analysis was in patients who were treated with chemoimmunotherapy and had a favorable PFS when they had mutated 

 status; this has been a group that has always benefited from chemoimmunotherapy, says Al-Sawaf.

With this follow-up analysis, venetoclax plus obinutuzumab has also been found to improve outcomes in this particular subgroup of patients, and therefore, all patients of all risk groups benefit from the regimen, concludes Al-Sawaf.

Othman Al-Sawaf, MD, discusses updated data from the phase 3 CLL14 trial in chronic lymphocytic leukemia.

Dr. Al-Sawaf on Updated PFS Data With Venetoclax Plus Obinutuzumab in CLL

Othman Al-Sawaf, MD, physician, University Hospital of Cologne, Cologne, Germany, discusses checking complex karyotype (CKT) in patients with chronic lymphocytic leukemia (CLL).

Patients with CLL should be checked for CKT before initiating therapy, explains Al-Sawaf. At the moment, according to Al-Sawaf, there are no data to indicate that patients who are asymptomatic should begin treatment, especially if they have a normal blood count. Rather, asymptomatic patients should abide by the watch-and-wait strategy.

When patients require treatment, Al-Sawaf suggests they be checked for CKT because there are direct therapeutic implications. Patients should be checked for CKT with their diagnostic workup, which includes 

 status, and CKT, says Al-Sawaf. This should be done before treatment starts because it will guide the treatment chosen for that patient.

Al-Sawaf also recommends testing for CKT at relapse. Additionally, if a patient completes treatment, relapses, and requires additional treatment, the patient should have their CKT checked in case they did not receive the test before, concludes Al-Sawaf.

Othman Al-Sawaf, MD, discusses checking complex karyotype in patients with chronic lymphocytic leukemia.

Othman Al-Sawaf, MD

Articles

Dr. Al-Sawaf on Continual MRD Assessment After Venetoclax/Obinutuzumab in CLL

Dr. Al-Sawaf on Fixed-Duration Versus Continuous Treatment in CLL

Dr. Al-Sawaf on Updated PFS Data With Venetoclax Plus Obinutuzumab in CLL

Dr. Al-Sawaf on Testing for CKT in CLL

Othman Al-Sawaf, MD

Articles

Dr. Al-Sawaf on Continual MRD Assessment ​After Venetoclax/Obinutuzumab in CLL

Dr. Al-Sawaf on Fixed-Duration Versus Continuous Treatment in CLL

Dr. Al-Sawaf on Updated PFS Data With Venetoclax Plus Obinutuzumab in CLL

Dr. Al-Sawaf on Testing for CKT in CLL

Dr. Al-Sawaf on Continual MRD Assessment After Venetoclax/Obinutuzumab in CLL