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ICML 2019 | CLL14: venetoclax-obinutuzumab improves PFS and MRD in untreated, reduced fitness CLL

The CLL14 trial (NCT02242942) investigated the use of venetoclax-obinutuzumab among patients with untreated chronic lymphocytic leukemia (CLL) with a higher age or reduced fitness. Michael Hallek, MD, PhD, University of Cologne, Cologne, Germany, discusses the trial here, where venetoclax-obinutuzumab was found to be associated with longer progression-free survival than chlorambucil-obinutuzumab. This interview took place at the 15th International Conference on Malignant Lymphoma (ICML), in Lugano, Switzerland.

Transcript

The CLL14 protocol was done in patients with higher age or reduced fitness with relevant comorbidity, and it tested the combination of venetoclax plus obinutuzumab versus chlorambucil plus obinutuzumab, the former standard in this group of patients.

The trial clearly shows that the progression-free survival is longer in a rate of PFS free or progression-free patients and two years is increased by I think another very important result is that the rate of minimal residual disease negative CLL, so MRD negative CLL, is strongly increased by the venetoclax plus obinutuzumab...

The CLL14 protocol was done in patients with higher age or reduced fitness with relevant comorbidity, and it tested the combination of venetoclax plus obinutuzumab versus chlorambucil plus obinutuzumab, the former standard in this group of patients.

The trial clearly shows that the progression-free survival is longer in a rate of PFS free or progression-free patients and two years is increased by I think another very important result is that the rate of minimal residual disease negative CLL, so MRD negative CLL, is strongly increased by the venetoclax plus obinutuzumab. It’s actually the highest MRD negative rate ever observed in any randomized trial so far; first line and the depth of the remission is impressive because we have 10-6 and less in approximately 40% of our patients.

For found remissions that seem to be long lasting, what we have not seen yet, is a survival difference in this trial, so we have to wait for longer follow-up to see whether those deeper missions translate into longer survival.

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