NHL: VEN+ R-/G-CHOP delivers high response, manageable safety

  • Zelenetz AD & al.
  • Blood
  • 8 Mar 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • Venetoclax (VEN) demonstrated manageable safety and high response when combined with an anti-CD20 antibody and CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) in patients with B-cell non-Hodgkin’s lymphoma (NHL).

Why this matters

  • This is the first study of VEN in combination with an anti-CD20 monoclonal antibody plus CHOP.

Study design

  • CAVALLI phase 1b study to investigate VEN in combination with rituximab (R) or obinutuzumab (G) plus CHOP in 56 patients with B-cell NHL.
  • Mean patient age, 60.3 (range, 37-79) years.
  • Funding: Genentech; AbbVie.  

Key results

  • Maximum tolerated dose not reached for VEN; recommended phase 2 dose was 800 mg on days 4-10 of cycle 1 and days 1-10 of cycles 2-8.
  • Responses with VEN+R-CHOP vs VEN+G-CHOP:
    • Overall response rate: 87.5% vs 87.5%.
    • Complete response (CR): 79.2% vs 78.1%.
    • CR in patients with diffuse large B-cell lymphoma (DLBCL): 80.0% vs 100%.
    • CR in patients with follicular lymphoma: 70.0% vs 80.0%.
  • In patients with DLBCL, 70% 1-year PFS with VEN+R-CHOP vs 100% with VEN+G-CHOP.
  • Most common grade 3/4 adverse events with VEN+R-CHOP/VEN+G-CHOP, respectively:
    • Neutropenia (54.2%/59.4%), febrile neutropenia (33.3%/25.0%), thrombocytopenia (16.7%/37.5%), and anemia (12.5%/31.3%).

Limitations

  • Limited sample size in each dose cohort.

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