Dr. Ritchie on Immunological Recovery With Venetoclax and Ibrutinib in MCL

David Ritchie, MD, PhD, hematologist, head of allogenic stem cell transplantation, Peter MacCallum Cancer Centre, discusses immunological recovery with venetoclax (Venclexta) and ibrutinib (Imbruvica) in mantle cell lymphoma (MCL).

The important take-home message from an immunological analysis in the phase II AIM study (NCT02471391) was that the responses to the combination took time to evolve. When the immunological status was analyzed at diagnosis or inclusion in the study, researchers looked at results 16 weeks later and saw no improvement in immunological status. However, there was complete normalization of the immunological status at 1 year posttreatment, which was sustained for 2 years posttreatment, says Ritchie.

This is important because, initially, exposure to venetoclax and ibrutinib can be associated with immunological impairment. However, the subsequent normalization and improvement in immune status likely reflects the lower rates of opportunistic infections that those patients saw on the clinical trial. It also reflects the potential for those patients to be treated with subsequent immunotherapy. Investigators of the trial felt that the findings were uniform across the group and associated with sustained responses, concludes Ritchie.