Venetoclax plus rituximab (VenR) versus BR

The prospective MURANO trial (NCT02005471) included 389 patients with relapsed or refractory CLL. Patients were randomly assigned to receive either VenR (venetoclax for 2 years plus rituximab for the first 6 months) or 6 months of BR.

The prospective MURANO trial (NCT02005471) included 389 patients with relapsed or refractory CLL. Patients were randomly assigned to receive either VenR (venetoclax for 2 years plus rituximab for the first 6 months) or 6 months of BR.

With a median follow-up of 24 months, the 2-year PFS rate was 84.9% for VenR and 36.3% for BR (HR, 0.17; 95% CI, 0.11–0.25; P < .001).[19,20] An update with a 48-month median follow-up, reported in abstract form, showed a 4-year OS rate of 85.3% for VenR and 66.8% for BR (HR, 0.41; 95% CI, 0.26−0.65; P < .0001).[21][Level of evidence A1]

The prospective MURANO trial (NCT02005471) included 389 patients with relapsed or refractory CLL. Patients were randomly assigned to receive either VenR (venetoclax for 2 years plus rituximab for the first 6 months) or 6 months of BR.

With a median follow-up of 59.2 months, the 5-year OS rate was 82.1% (95% CI, 76.4%–87.8%) for patients who received VenR and 62.2% (95% CI, 54.8%–69.6%) for patients who received BR (P < .0001).[22][Level of evidence A1] The median time to next treatment was 57.8 months (95% CI, 55.1–not estimable) for VenR.

The prospective MURANO trial (NCT02005471) included 389 patients with relapsed or refractory CLL. Patients were randomly assigned to receive either VenR (venetoclax for 2 years plus rituximab for the first 6 months) or 6 months of BR.

For the 43% of patients assigned to VenR who achieved undetectable MRD at the end of treatment, the median time to MRD conversion was 19.4 months. The median time from MRD conversion to overt clinical progressive disease was another 25.2 months.[22]