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FDA approved Venclexta (venetoclax) for CLL/SLL and AMLFDA approved new drug Venclexta for certain blood cancers

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Key Takeaway
Consider TLS prophylaxis before starting Venclexta due to risk of rapid tumor reduction.

The FDA has approved Venclexta (venetoclax), a BCL-2 inhibitor, for the treatment of adult patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). Additionally, Venclexta is approved in combination with azacitidine, decitabine, or low-dose cytarabine for newly diagnosed acute myeloid leukemia (AML) in adults aged 75 years or older, or those with comorbidities that preclude intensive induction chemotherapy. This approval provides a new oral targeted therapy option for these hematologic malignancies. Venclexta works by inhibiting BCL-2, a protein that promotes survival of cancer cells. The approval underscores the importance of tumor lysis syndrome prophylaxis, as Venclexta can cause rapid tumor reduction. Clinicians should assess patient risk for TLS and provide appropriate hydration and anti-hyperuricemics prior to the first dose.

Clinical Details (Mechanism · Dosing · Trial Data · Warnings)
Mechanism of Action

VENCLEXTA is a BCL-2 inhibitor. BCL-2 is an anti-apoptotic protein that is overexpressed in some cancer cells, promoting their survival. Venetoclax binds directly to BCL-2, displacing pro-apoptotic proteins and restoring the apoptotic process.

Indication & Patient Population

VENCLEXTA is indicated for the treatment of adult patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). It is also indicated in combination with azacitidine, or decitabine, or low-dose cytarabine for the treatment of newly diagnosed acute myeloid leukemia (AML) in adults 75 years or older, or who have comorbidities that preclude use of intensive induction chemotherapy.

Dosing & Administration

For CLL/SLL, VENCLEXTA dosing begins with a 5-week ramp-up schedule: Week 1: 20 mg, Week 2: 50 mg, Week 3: 100 mg, Week 4: 200 mg, Week 5 and beyond: 400 mg orally once daily. For AML, the ramp-up is 3 or 4 days: Day 1: 100 mg, Day 2: 200 mg, Day 3: 400 mg, then 400 mg once daily with azacitidine or decitabine, or 600 mg once daily with low-dose cytarabine. Take tablets orally once daily with a meal and water. Do not chew, crush, or break tablets. Provide prophylaxis for tumor lysis syndrome.

Key Clinical Trial Data

Trial data not available in label.

Warnings & Contraindications

Patients treated with VENCLEXTA may develop tumor lysis syndrome (TLS). Assess patient-specific factors for level of risk of TLS and provide prophylactic hydration and anti-hyperuricemics prior to first dose to reduce risk of TLS.

Place in Therapy

VENCLEXTA is indicated for CLL/SLL as monotherapy or in combination with acalabrutinib, obinutuzumab, or rituximab. For AML, it is used in combination with azacitidine, decitabine, or low-dose cytarabine in older adults or those with comorbidities.

The FDA has approved a new drug called Venclexta (venetoclax) for adults with certain types of blood cancer. Venclexta is a targeted therapy that works by blocking a protein called BCL-2, which helps cancer cells survive. By blocking this protein, the drug can help kill cancer cells.

Venclexta is approved for two main uses. First, it is for adults with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). Second, it is for adults aged 75 or older with newly diagnosed acute myeloid leukemia (AML), or for those who cannot have strong chemotherapy. For AML, Venclexta is used together with other drugs like azacitidine or decitabine.

This approval gives patients a new oral treatment option, which can be taken at home. However, Venclexta can cause a serious side effect called tumor lysis syndrome, where cancer cells break down too quickly. Doctors will monitor patients closely and may give fluids or other medicines to prevent this.

If you or a loved one has CLL, SLL, or AML, talk to your doctor about whether Venclexta might be right for you. This approval does not mean it is the best option for everyone. Your doctor can help weigh the benefits and risks based on your specific health situation.

What this means for you:
Venclexta is a new oral drug for certain blood cancers, but talk to your doctor about risks like tumor lysis syndrome.

Study Details

Study typeFda approval
PublishedApr 2016
View Original Abstract ↓
1 INDICATIONS AND USAGE VENCLEXTA is a BCL-2 inhibitor indicated: For the treatment of adult patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). ( 1.1 ) In combination with azacitidine, or decitabine, or low-dose cytarabine for the treatment of newly diagnosed acute myeloid leukemia (AML) in adults 75 years or older, or who have comorbidities that preclude use of intensive induction chemotherapy. ( 1.2 ) 1.1 Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma VENCLEXTA is indicated for the treatment of adult patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). 1.2 Acute Myeloid Leukemia VENCLEXTA is indicated in combination with azacitidine, or decitabine, or low-dose cytarabine for the treatment of newly diagnosed acute myeloid leukemia (AML) in adults 75 years or older, or who have comorbidities that preclude use of intensive induction chemotherapy.
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