MRD-guided discontinuation of first-line ibrutinib plus venetoclax for CLL

Continuous single-agent ibrutinib affords survival benefit in the first-line treatment of chronic lymphocytic leukemia (CLL), but there is increasing desire for convenient time-limited treatment options. The multinational phase II CAPTIVATE study evaluated minimal residual disease (MRD)-guided treatment discontinuation following combination treatment with ibrutinib plus venetoclax in patients with previously untreated CLL. After 12 cycles of ibrutinib plus venetoclax patients with confirmed undetectable MRD were randomized to double-blind placebo or ibrutinib. The one-year DFS rates were not significantly different between both groups. The authors conclude that the study results suggest the potential for fixed-duration treatment with this all-oral, once-daily, chemotherapy-free regimen in first-line CLL.