Medically reviewed by Dr. Brian Koffman
The Bottom Line:
For patients with Richter’s transformation, the combination of ibrutinib, venetoclax, and obinutuzumab may be most useful as a bridge to other therapies. While the triple combination therapy initially produced high response rates, these responses were not durable.
Who Performed the Research and Where Was it Presented:
Dr. Tamar Tadmor from Bnai-Zion Medical Center and colleagues presented the results at the American Society for Hematology (ASH) Annual Meeting 2023.
Background:
There is a significant unmet need for effective therapies for Richter’s transformation. Richter’s transformation is a rare complication of chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL), where the disease turns into an aggressive lymphoma known as diffuse large B cell lymphoma (DLBCL). Richter’s transformation has an inferior prognosis and few treatment options. Most patients are treated with the chemoimmunotherapy combination R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). However, responses are generally not durable, and better treatments are desperately needed.
Methods and Participants:
This is a phase 2 clinical trial of one year of fixed-duration treatment with a combination of ibrutinib, venetoclax, and obinutuzumab in patients with Richter’s transformation.
Results
- Ten patients were enrolled in the trials, and the median follow-up thus far is nine months.
- The overall response rate was 70% at three months and 22% at six months.
- The complete response rate was 40% at three months and 11% at six months.
- At the time of data cut-off, 60% of patients had progressed, and 50% had died.
- Enrollment in this trial is now closed.
Conclusion:
The triple combination of ibrutinib, venetoclax, and obinutuzumab initially produced high response rates in patients with Richter’s transformation, but these responses were not durable. This therapy may be most useful as a bridge to other therapies, such as allogeneic stem cell transplant or CAR-T therapy.
Links and Resources:
Watch the interview on the abstract here:
You can read the ASH abstract: A Prospective, Phase-II Study to Evaluate the Efficacy and Safety of Obinutuzumab, Ibrutinib, and Venetoclax (GIVeRS) in Patients with Richter’s Syndrome.
Take care of yourself first.
Ann Liu, PhD
