The most commonly prescribed fixed-duration treatment combination for CLL is venetoclax (Venclexta, AbbVie) and obinutuzumab (Gazyva, Genentech), also known as VenO. 

When are Venetoclax + Obinutuzumab Used?

The approved indication for venetoclax and obinutuzumab in CLL is for the first-line treatment or previously untreated adult patients with CLL. 

This combination is a fixed-duration therapy and is typically given for 12 months and then discontinued.

How are Venetoclax + Obinutuzumab Administered?

When prescribed VenO combination therapy to treat your CLL, you can expect to receive obinutuzumab first. After starting obinutuzumab, venetoclax is introduced into your treatment regimen.

As referenced earlier in the guide, click here to learn about how venetoclax is administered. 

Obinutuzumab is administered as an intravenous infusion (IV), usually in six cycles, each lasting 28 days. 

In the first cycle, obinutuzumab is given on specific days: 

• 100 mg on day 1
• 900 mg on day 2
• 1,000 mg on day 8
• 1,000 mg on day 15

The frequency decreases in cycles 2-6. On the first day of these remaining cycles, you will receive 1,000 mg of obinutuzumab. 

The infusion administration time ranges between 3 to 5 hours, potentially shortening to 90 minutes starting from cycle 2, depending on your response to the medicine in previous infusions.

A Note About Your First Infusion

People with CLL often experience reactions during their first obinutuzumab infusion. Because of this, patients are closely monitored by an infusion nurse who checks for symptoms every few minutes.

It is also important for you to communicate any symptoms you may experience, such as rash, shallow breathing, heart racing, or flushing. If you experience these, your healthcare team will pause the infusion and provide remedies like oxygen and anti-inflammatory steroids. After a waiting period of up to 1 hour, they will start the infusion again. Most patients can resume the infusion without further issues. If your symptoms do not improve after your first infusion, you may need to discontinue further infusions. 

Note: Some patients may require pre-treatment with a steroid before each obinutuzumab infusion to prevent reactions. 

For patient perceptions of this therapy combination, visit this section of the guide: Fixed-Duration Therapies Patient Perspective.