Dr. Davids on Investigational Doublets and Triplets in CLL

Matthew S. Davids, MD, MMSc, director of clinical research in the Lymphoma Program and a medical oncologist with Dana-Farber Cancer Institute, as well as an assistant professor of medicine at Harvard Medical School, discusses investigational doublets and triplets in chronic lymphocytic leukemia (CLL).

The ongoing phase 2 CAPTIVATE trial is evaluating ibrutinib (Imbruvica) in combination with venetoclax (Venclexta) in patients with treatment-naïve CLL/small lymphocytic lymphoma.

According to Davids, the doublet elicits increased toxicity compared with ibrutinib or venetoclax alone; however, the efficacy of the regimen is promising.

Giving ibrutinib plus venetoclax early in the course of treatment may allow the regimen to be given as a time-limited, all-oral option, Davids says. Such an approach may be more advantageous for patients versus venetoclax plus obinutuzumab (Gazyva).

Additionally, data from The Ohio State University and a German group have demonstrated promising findings with the triplet of ibrutinib, venetoclax, and obinutuzumab (IVO) in patients with TP53-mutant CLL, says Davids.

IVO appears to be highly efficacious for patients, Davids explains. However, it does increase the risk of toxicity, including infection and infusion-related reactions.

Data with the triplet may shed light on whether adding obinutuzumab to ibrutinib/venetoclax is beneficial for patients with CLL, concludes Davids.