Dr. Ghia on the Rationale for the CAPTIVATE Trial in CLL

Paolo Ghia, MD, PhD, full professor, Medical Oncology, head, Strategic research program on CLL Università Vita Salute San Raffaele, deputy director, Division of Experimental Oncology, San Raffaele Scientific Institute, discusses the rationale for the phase 2 CAPTIVATE trial (NCT02910583) in chronic lymphocytic leukemia (CLL).

The CAPTIVATE trial evaluated the fixed-duration combination ibrutinib (Imbruvica) plus venetoclax (Venclexta) as first-line treatment for patients with CLL or small lymphocytic lymphoma.

The rationale for the study was based on the synergistic effects demonstrated by combining ibrutinib and venetoclax, says Ghia. Single-agent ibrutinib can relieve cancer cells from the lymphoid tissue microenvironment into circulation where they are prone to undergo apoptosis, Ghia explains.

The addition of venetoclax will exacerbate that effect and lead to more effective apoptosis, Ghia says. In turn, resting and dividing leukemic cells can be eliminated, Ghia adds. Additionally, proliferative CLL cells can be mobilized out of lymph nodes and other protective lymphoid niche areas, which prevents further disease from developing, concludes Ghia.