What Is The Role Of Venclexta In Treating CLL?
- Venclexta (venetoclax) is an targeted therapy option for patients with chronic lymphocytic leukemia (CLL).
- Venclexta (venetoclax) treatment can be very successful in treating patients with CLL, but careful monitoring is necessary. A rare side effect is tumor lysis syndrome, which is when a tumor breaks open too quickly and releases toxins into the blood stream.
- About half of people who received Venclexta and Gazyva and in one study had a complete response, which means they no longer had any signs of cancer.
Venetoclax treatment can be very successful in treating patients, but careful monitoring is necessary. One of the known side effects of venetoclax is something called tumor lysis syndrome, which is when a tumor breaks open too quickly and releases toxins into the blood stream. This could be dangerous for the kidneys and the heart.
Read MoreWho Can Take Venclexta?
Venetoclax is FDA-approved:- In combination with obinutuzumab (Gazyva) for patients with CLL who have not been previously treated. Obinutuzumab is a type of drug called a monoclonal antibody. It works by targeting a CD20 antigen, a protein found on B cells (which, in the case of CLL, are cancerous.) “The advantage of this option is that this is a one year time-limited therapy, so whereas patients remain on Ibrutinib (another treatment for CLL) until it is no longer working for them, patients who are treated with Venetoclax can be treated for a one year period, which is appealing for some patients,” says Dr. Jennifer Crombie, an oncologist at Dana Farber Cancer Institute.
- In combination with rituximab (Rituxan) for the treatment of people with CLL, with or without 17p deletion, who have received at least one prior therapy. Rituximab is also a monoclonal antibody. (17p deletion refers to a missing part of a chromosome. When it is missing, cells lack the protein necessary to repair damaged DNA and kill off cells that can’t be repaired. Leukemia cells lacking this protein continue to grow.)
Getting Venclexta: What to Expect
When you get venetoclax (Venclexta) and obinutuzumab (Gazyva) in combination, you'll start with Gazyva. It comes as an infusion that your health care provider gives you into a vein. You'll have a couple of infusions in the first week, and then one infusion a week for a couple of weeks after that. After that, you'll switch to monthly infusions.
Near the end of your first month or at the beginning of your second month, you'll start taking Venclexta. This drug targets a protein called BCL2 on the surface of your cancer cells. Venclexta comes as a pill, which may be easier to take, but you won't be able to avoid needles altogether.
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"Unfortunately, because of the risk to the kidneys, we have to keep a very close eye on the kidney function using blood work," Dr. James Gerson, hematologist at Penn Medicine, tells SurvivorNet. You may need to get blood work the day before, the day of, and the day after your cancer treatment, he adds.
All of that blood work is essential to get your dose just right. Doctors start Venclexta at a low dose and then gradually increase it, looking all the while for evidence that the drug may be harming your kidneys.
Dr. Matthew Davids on the role of Venclexta in treating CLL
What to Know About Side Effects
The blood work and frequent trips to your doctor can be annoying, "but that’s the worst of it," Dr. Gerson says. Once you get through that short period of time when your dose is being adjusted, you should be finished with the worst part of your treatment.
Venclexta is generally a very safe medication, according to Dr. Gerson. The most common side effects include:
- Low white blood cell and red blood cell counts
- Diarrhea
- Fatigue
- Nausea
- Upper respiratory tract infections
If you can tolerate the side effects and the blood draws, you'll get the benefit of a combination treatment that has been shown to be very effective against CLL. About half of people who received Gazyva and Venclexta in one study had a complete response, which means they no longer had any signs of cancer.
"And so, if you can make it through the hassles of the first two months, then it’s a lot of smooth sailing," Dr. Gerson says. "And usually you’re fine after that."
What To Ask Your Doctor
- Is Venclexta a medication that could her treat my CLL?
- How does Venclexta work?
- What side effects should I be aware of?
- How will we monitor if Venclexta is working for me?
Contributing: Laura Gesualdi-Gilmore
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