Oncology Learning NetworkUpdates in CLL Treatment: 5-Year Off-Treatment Analyses From the CLL14 and MURANO Trials

Recent 5-year off-treatment analyses from the CLL14 and MURANO trials demonstrate sustained efficacy of venetoclax-based regimens in chronic lymphocytic leukemia (CLL) treatment. The studies compared venetoclax combinations against standard therapies in both treatment-naïve and previously treated CLL patients, providing important long-term data on progression-free survival and treatment-free periods.

Key Points:

• CLL14 trial showed venetoclax plus obinutuzumab achieved median PFS of 76.2 months versus 36.4 months with chlorambucil plus obinutuzumab in treatment-naïve patients
• In CLL14, 65.2% of venetoclax-obinutuzumab patients remained treatment-free at 5 years post-completion compared to 37.1% in the chlorambucil arm
• MURANO trial demonstrated median PFS of 54.7 months with venetoclax-rituximab versus 17 months with bendamustine-rituximab in previously treated patients
• Venetoclax retreatment in MURANO achieved 72% overall response rate among qualifying relapsed patients
• Common grade ≥3 adverse events included neutropenia (56-62%), with decreased incidence during single-agent treatment periods

HCN Medical Memo
The 5-year analyses reinforce venetoclax-based fixed-duration regimens as effective options for both treatment-naïve and previously treated CLL patients, offering extended treatment-free periods without compromising efficacy.

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