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ASH 2024 | Combining pirtobrutinib, venetoclax, and obinutuzumab as first-line treatment for patients with CLL
Nitin Jain, MD, The University of Texas MD Anderson Cancer Center, Houston, TX, comments on the potential of combining pirtobrutinib, venetoclax, and obinutuzumab as a first-line treatment for patients with chronic lymphocytic leukemia (CLL), highlighting the high rates of measurable residual disease (MRD) negativity achieved with this combination in 80 patients treated at his institution. This interview took place at the 66th ASH Annual Meeting and Exposition, held in San Diego, CA.
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Transcript (AI-generated)
So the options for treatment of patients with CLL have expanded greatly in the last decade or so. And there are many BTK inhibitors which are now available, including covalent BTK inhibitors namely ibrutinib, acalabrutinib, and zanubrutinib. And more recently we have a non-covalent BTK inhibitor pirtobrutinib approved in relapsed/refractory CLL. In this particular investigator initiative trial done at MD Anderson, we argued that combining pirtobrutinib, a non-covalent BTK inhibitor, in a time-limited fashion of one year along with venetoclax and obinutuzumab would be highly synergistic...
So the options for treatment of patients with CLL have expanded greatly in the last decade or so. And there are many BTK inhibitors which are now available, including covalent BTK inhibitors namely ibrutinib, acalabrutinib, and zanubrutinib. And more recently we have a non-covalent BTK inhibitor pirtobrutinib approved in relapsed/refractory CLL. In this particular investigator initiative trial done at MD Anderson, we argued that combining pirtobrutinib, a non-covalent BTK inhibitor, in a time-limited fashion of one year along with venetoclax and obinutuzumab would be highly synergistic.
So the data we’re going to show at ASH, we report data on 80 patients where we have done one year of therapy where patients get obinutuzumab for six months and pirtobrutinib and venetoclax for one year. And what we’re seeing in the study is very high rates of MRD4 as well as MRD6 remission both in blood and marrow as assessed by next generation sequencing assay. Probably one of the highest at least we have seen at our institution and many of the comparative studies across the world. And also the toxicity profile seems to be similar to other doublets and triplets which have been done in this disease. So far with the median follow-up of about one year, we have not seen any progression or any death on the study. So we continue to enroll patients on this study and hopefully we’ll present updated data at the next year’s meeting.
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Disclosures
Newave: Research Funding; TG Therapeutics: Consultancy, Honoraria, Other: Travel Support; Kite, a Gilead Company: Consultancy, Honoraria, Other: Travel Support, Research Funding; Dialectic Therapeutics: Research Funding; TransThera Sciences: Research Funding; Fate Therapeutics: Research Funding; Servier: Research Funding; Takeda: Research Funding; Pfizer: Research Funding; Aprea Therapeutics: Research Funding; Precision Biosciences: Consultancy, Honoraria, Other: Travel Support, Research Funding; NovalGen: Research Funding; ADC Therapeutics: Research Funding; Ipsen: Consultancy, Honoraria, Other: Travel Support; MEI Pharma: Consultancy, Honoraria, Other: Travel Support; Pharmacyclics: Consultancy, Honoraria, Other: Travel Support, Research Funding; Janssen: Consultancy, Honoraria, Other: Travel Support; Genentech: Consultancy, Honoraria, Other: Travel Support, Research Funding; Cellectis: Consultancy, Honoraria, Other: Travel Support, Research Funding; CareDx: Consultancy, Honoraria, Other: Travel Support; Bristol Myers Squibb: Consultancy, Honoraria, Other: Travel Support, Research Funding; BeiGene: Consultancy, Honoraria, Other: Travel Support; AstraZeneca: Consultancy, Honoraria, Other: Travel Support, Research Funding; Adaptive Biotechnologies: Consultancy, Honoraria, Other: Travel Support, Research Funding; AbbVie: Consultancy, Honoraria, Other: Travel Support, Research Funding; Incyte: Research Funding; Loxo Oncology: Research Funding; Medisix: Research Funding; MingSight: Honoraria, Research Funding.
