Reducing Tumor Lysis Syndrome Risk with Venetoclax in CLL
June 18, 2025
The risk of dangerous tumor lysis syndrome, when venetoclax is started, has limited its use in the community.
The risk of dangerous tumor lysis syndrome, when venetoclax is started, has limited its use in the community.
Tumor lysis syndrome is a rare condition that can happen due to the rapid death of cancer cells.
Tumor lysis syndrome is a rare condition that can happen due to the rapid death of cancer cells. When the cancer cells are killed, the debris from inside the cells enters the bloodstream.
Atezolizumab, obinutuzumab, and venetoclax combination therapy is active in patients with untreated DLBCL-Richter’s Syndrome (RS).
Early results from a phase 1b/2 trial show that epcoritamab has a manageable safety profile and an encouraging response rate in patients with Richter syndrome.
Ibrutinib and Venetoclax have as we like to say at the CLL Society orthogonal or complementary mechanisms of action. Ibrutinib inhibits chronic lymphocytic leukemia or CLL cells’ proliferation and gets the cancer cells out of their protective niches in the nodes and bone marrow and into the blood stream where they are easier to kill.
The CAPTIVATE study data has been highly anticipated. At ASH 2020, we got important results. Dr. Wierda presented the results of Minimal (Measurable) Residual Disease (MRD) cohort using MRD status to guide therapy: Undetectable MRD (uMRD) was achieved in >2/3 of patients with 12 cycles of I+V, and the 30 months progression free survival or PFS rates was an impressive ≥95%.
In this study, venetoclax ramp-up without prior anti-CD20 antibody therapy was safe for patients with CLL with a low rate of tumor lysis syndrome.
So far, so good. 11 hours post-dosing, labs show no hint of Tumor Lysis Syndrome (TLS), and more importantly, I feel fine with 100 mg of oral prednisone as premedication to lower the risk of Cytokine Release Syndrome (CRS) and ICANS (Immune effector Cell-Associated Neurotoxicity Syndrome