Dr. Ritchie on the Immunologic Impact of Long-Term Venetoclax/Ibrutinib in R/R MCL

David Ritchie, MD, PhD, hematologist, head of allogenic stem cell transplantation, Peter MacCallum Cancer Centre, discusses the immunologic impact of long-term venetoclax (Venclexta) and ibrutinib (Imbruvica) in relapsed/refractory mantle cell lymphoma (MCL).

The phase II AIM trial (NCT02471391) evaluated ibrutinib and venetoclax in patients with relapsed/refractory MCL. At 16 weeks, the overall response rate was 71%. Of 24 patients treated, 16 remained on the combination for more than 1 year.

A subset analysis presented at the 2019 ASH Annual Meeting confirmed that long-term treatment with the combination is associated with immune recovery, as well as changes in inflammatory biomarkers. The majority of patients showed normalization in their immune status, says Ritchie.

As such, it is hypothesized that if normalization occurs within a year of starting treatment with venetoclax/ibrutinib, the antitumor response could be sustained beyond that. Moreover, patients with a normalized immune system may respond better to subsequent therapy upon disease progression, concludes Ritchie.