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How it is administered
Venetoclax is taken by mouth as a tablet. Tablets are available in strengths of 10 mg, 50 mg, and 100 mg. The medication should be swallowed whole with a meal and water, at approximately the same time each day. Do not chew, crush, or break the tablets.
Venetoclax is started at a low dose and gradually increased over several weeks (called a ramp-up schedule) to reduce the risk of tumor lysis syndrome (TLS). Your doctor will give you specific instructions on how to take the medication and how to increase your dose.
How it works
Venetoclax is a targeted therapy that works by blocking a protein called BCL-2. BCL-2 is found in high levels in certain blood cancer cells, including some lymphomas and leukemias, and helps these cancer cells survive longer than normal. By blocking BCL-2, venetoclax helps restore the natural process of cell death (apoptosis), allowing cancer cells to die off.
This mechanism is particularly important in blood cancers where BCL-2 is overexpressed, such as chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL). While venetoclax is not specifically approved for follicular lymphoma, its action on BCL-2 may be relevant in some cases of blood cancers where this protein is involved. The medication is designed to selectively target cancer cells, which may help reduce damage to normal cells.
Common side effects
Common side effects of venetoclax include:
- Neutropenia (low white blood cell count)
- Thrombocytopenia (low platelet count)
- Anemia (low red blood cell count)
- Diarrhea
- Nausea
- Upper respiratory tract infection
- Cough
- Musculoskeletal pain
- Fatigue
- Edema (swelling)
Serious side effects can include tumor lysis syndrome (TLS), infections, and severe neutropenia. Always report any unusual symptoms to your healthcare provider right away.
Who Should take it
Venetoclax is approved for adults with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL), either alone or in combination with other medications. It is also used in combination with other drugs (such as azacitidine, decitabine, or low-dose cytarabine) for newly diagnosed acute myeloid leukemia (AML) in adults who are 75 years or older, or who have health conditions that make them unable to receive intensive chemotherapy.
For follicular lymphoma, venetoclax is not currently an approved treatment, but your doctor may consider it in special circumstances or as part of a clinical trial if your cancer expresses high levels of BCL-2. Always discuss with your healthcare provider whether venetoclax is appropriate for your specific situation.
Who should not take it
Venetoclax should not be taken by patients who are taking strong CYP3A inhibitors at the start and during the ramp-up phase, as this can increase the risk of tumor lysis syndrome (TLS), a potentially life-threatening complication. Examples of strong CYP3A inhibitors include certain antifungals and antibiotics.
Venetoclax is not recommended for use in children, as its safety and effectiveness have not been established in pediatric patients. Women who are pregnant or breastfeeding should not take venetoclax, as it may harm the unborn baby or nursing infant. Always inform your doctor about all medications and supplements you are taking before starting venetoclax.
Commonly used with
Venetoclax is often used in combination with other medications for blood cancers. For CLL/SLL, it may be combined with obinutuzumab or rituximab. For AML, it is used with azacitidine, decitabine, or low-dose cytarabine.
These combinations are chosen to improve treatment effectiveness and are tailored to each patient's specific type of cancer and overall health.
Commonly tested with
Venetoclax has been tested with a variety of other medications in clinical trials, especially in the treatment of blood cancers. Common combinations include rituximab, obinutuzumab, azacitidine, decitabine, and low-dose cytarabine.
Researchers continue to study venetoclax in combination with other therapies to find the most effective regimens for different types of blood cancers, including those that may share characteristics with follicular lymphoma.