Venetoclax: a chance for patients with chronic lymphocytic leukaemia previously treated with ibrutinib

Commentwww.thelancet.com/oncology Vol 19 January 20187Biotheranostics, Exelixis, Bristol-Myers-Squibb, Janssen, Amgen, and Eisai; receives personal fees from NCCN (National Comprehensive Cancer Network); and receives institutional research funding and support from Boehringer-Ingelheim, Bayer, Onyx-Amgen, and Merck. TKC receives honoraria forAlligent, AstraZeneca, Bayer, Bristol-Myers Squibb, Cerulean Pharma, Eisai, Exelixis, Foundation Medicine, GlaxoSmithKline, Merck, Novartis, Peloton, Pfizer, Prometheus, and Roche/Genentech; institutional research funding and support from Pfizer, Exelixis, Bristol-Myers Squibb, Novartis, Peloton, AstraZeneca, Agensys, and TRACON. A-KAL declares no competing interests. 1Rosenberg JE, Hoffman-Censits J, Powles T, et al. Atezolizumab in patients with locally advanced and metastatic urothelial carcinoma who have progressed following treatment with platinum-based chemotherapy: a single-arm, multicentre, phase 2 trial. Lancet 2016; 387: 1909–20.2Sharma P, Retz M, Siefker-Radtke A, et al. Nivolumab in metastatic urothelial carcinoma after platinum therapy (CheckMate 275): a multicentre, single-arm, phase 2 trial. Lancet Oncol 2017; 18: 312–22.3Bellmunt J, de Wit R, Vaughn DJ, et al. Pembrolizumab as second-line therapy for advanced urothelial carcinoma. N Engl J Med 2017; 376: 1015–26.4Powles T, O’Donnell PH, Massard C, et al. Efficacy and safety of durvalumab in locally advanced or metastatic urothelial carcinoma: updated results from a phase 1/2 open-label study. JAMA Oncol 2017; 3: e172411. 5Patel MR, Ellerton J, Infante JR, et al. Avelumab in metastatic urothelial carcinoma after platinum failure (JAVELIN Solid Tumor): pooled results from two expansion cohorts of an open-label, phase 1 trial. Lancet Oncol2017; published online Dec 4. http://dx.doi.org/10.1016/S1470-2045(17)30900-2. 6Pond GR, Sonpavde G, Rosenberg JE, et al. Nomogram to assess benefit of new over historical agents as salvage therapy for metastatic urothelial carcinoma (mUC) in non-randomized trials: effect of atezolizumab on 12-month survival. J Clin Oncol 2017; 35: 346.7Boyerinas B, Jochems C, Fantini M, et al. Antibody-dependent cellular cytotoxicity activity of a novel anti-PD-L1 antibody avelumab (MSB0010718C) on human tumor cells. Cancer Immunol Res 2015; 3: 1148–57.8Martini DJ, Lalani AA, Bosse D, et al. Response to single agent PD-1 inhibitor after progression on previous PD-1/PD-L1 inhibitors: a case series. J Immunother Cancer 2017; 5: 66.9Petrylak DP, de Wit R, Chi KN, et al. Ramucirumab plus docetaxel versus placebo plus docetaxel in patients with locally advanced or metastatic urothelial carcinoma after platinum-based therapy (RANGE): a randomised, double-blind, phase 3 trial. Lancet 2017; 390: 2266–77.10Powles T. IMvigor211: a phase III randomized study examining atezolizumab versus chemotherapy for platinum-treated advanced urothelial carcinoma. EACR-AACR-SIC Special Conference: Florence, Italy; June 24–27, 2017. Abstract 606.In recent years, biological and clinical research has identified several targeted agents that are changing the management of patients with chronic lymphocytic leukaemia. In clinical trials,1 the B-cell receptor inhibitor ibrutinib has led to durable responses and longer survival (overall and progression-free) than chemotherapy in patients with this disease. Ibrutinib is now largely used in clinical practice in patients with chromosome 17p deletions or TP53 mutations and relapsed or refractory chronic lymphocytic leukaemia.