Venetoclax (Venclexta) and rituximab (Rituxan) are used in combination with relapsed / refractory chronic lymphocytic leukemia ( CLL ), resulting in a high rate of undetectable minimal residual disease ( uMRD ), which is associated with prolonged progression-free survival ( PFS ).
Venetoclax and rituximab-treated patients had almost 5 times the uMRD status as combined with phenytoin and rituximab , and the proportion of patients who maintained this status at 24 months was higher in the venetoclax / rituximab group the 20 or more times. Compared with MRD- positive status, uMRD was associated with a 62 % reduction in risk of disease progression or death .
The MRD status has been proven to predict PFS in CLL patients treated with chemoimmunotherapy , but the predictive value of MRD for new drugs remains uncertain. Data from the random MURANO trial provides an opportunity to examine the predictive value of MRD and CLL without chemotherapy.
MURANO is a phase III randomized trial evaluating the efficacy of rituximab combined with venetoclax versus bendamustine in 389 patients with relapsed / refractory CLL . The patient received 2 years of venetoclax and the first 6 months of rituximab, or 6 months of bendamustine plus rituximab for 6 months.
Preliminary analysis showed that compared with rituximab and bendamustine, the risk of disease progression or death was 84% at 3 years of treatment with venetoclax and rituximab.