Ibrutinib in combination with venetoclax for chronic lymphocytic leukaemia or small lymphocytic lymphoma – first line

Ibrutinib in combination with venetoclax is being developed for elderly and at risk patients with chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL). CLL and SLL are types of cancer in which too many white blood cells are produced, in SLL cells build up in the lymph nodes, in CLL the cancer cells can be found in the blood and bone marrow. As these cells develop abnormally, they are unable to function, fight infection and reduce the production of healthy blood cells. These diseases are chronic and develop slowly. Treatment is complex and depends on a number of factors, including the extent of disease, previous treatment, patient’s age, symptoms and general state of health.
Ibrutinib is an oral drug that works against cancerous B lymphocytes, which are a type of white blood cells affected by these diseases. It does this by blocking an enzyme called Bruton’s tyrosine kinase (BTK), which promotes survival of B lymphocytes. By blocking BTK, ibrutinib decreases the survival and migration of B lymphocytes, thereby delaying the progression of cancer. Venetoclax, attaches to a protein called BCL-2 that is present in high amounts in CLL cancer cells. By attaching BCL-2 and blocking its actions, venetoclax causes the death of cancer cells. If licensed, ibrutinib in combination with venetoclax will offer an additional first-line treatment option for elderly and at risk patients with CLL or SLL, potentially avoiding the use of chemotherapy.