When is Venetoclax Used?

Venetoclax has shown significant and long-lasting responses in patients with relapsed or refractory chronic lymphocytic leukemia, even in those with poor prognostic factors.

It is typically prescribed as a fixed-duration therapy used for one year in combination with the monoclonal antibody obinutuzumab for first-time treated CLL, or two years with rituximab for subsequent treated CLL of two years. 

Venetoclax may, in certain cases, be recommended by itself as a continuous-duration therapy. Click here to learn more. 

How Does Venetoclax Work?

Venetoclax targets and kills cancerous CLL cells by blocking the BCL-2 protein, which regulates B-cell survival and death. Overproduction of BCL-2 is common in CLL cells, and its blockage with venetoclax leads to the death of these cancer cells. However, venetoclax may also kill healthy B-cells. 

How is Venetoclax Administered?

Venetoclax is taken by mouth in the form of a tablet. It requires a special approach called "ramp-up dosing." This means that the dose of venetoclax is gradually increased over 5 weeks. 

Venetoclax ramp-up dosing mitigates the risk of tumor lysis syndrome (TLS), a rare but potentially life-threatening condition caused by the rapid destruction of cancer cells. This gradual increase in dosage allows the body to adjust to the medication while monitoring and managing any side effects. 

Carefully increasing the dose over time ensures safer treatment effectiveness in patients, particularly those with high-risk factors for TLS. 

Venetoclax Ramp-up Dosing Schedule

• First week: 20 mg once daily
• Second week: 50 mg once daily
• Third week: 100 once daily
• Fourth week: 200 mg once daily (two 100 mg tablets)
• Fifth week: 400 mg once daily (four 100 mg tablets) 

From week six onward, you will continue to take 400 mg once daily until the fixed-duration treatment ends.