Common brand names

• Venclexta

How it is administered

Venetoclax is taken by mouth as a tablet. It is available in strengths of 10 mg, 50 mg, and 100 mg. The tablets should be swallowed whole with a meal and water, and should not be chewed, crushed, or broken. The dosing schedule usually starts with a low dose that is gradually increased over several weeks to reduce the risk of side effects such as tumor lysis syndrome. Always follow your healthcare provider's instructions for dosing and administration.

How it works

Venetoclax is a targeted cancer therapy known as a BCL-2 inhibitor. BCL-2 is a protein that helps cancer cells survive by preventing them from undergoing programmed cell death (apoptosis). In certain blood cancers, including some leukemias, BCL-2 is overproduced, making the cancer cells more resistant to standard treatments.

Venetoclax works by binding directly to the BCL-2 protein, blocking its function. This action releases pro-apoptotic proteins, which then trigger the cancer cells to undergo apoptosis. By restoring this natural cell death process, venetoclax helps to reduce the number of cancer cells in the body. This mechanism is particularly important in blood cancers where BCL-2 is a key factor in cancer cell survival and resistance to therapy.

Who should take it

Venetoclax is approved for the treatment of adults with certain blood cancers, specifically chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), and in combination with other medicines for newly diagnosed acute myeloid leukemia (AML) in adults who are 75 years or older, or who have health problems that prevent them from receiving intensive chemotherapy.

While there is no specific FDA approval for T-Cell Prolymphocytic Leukemia (T-PLL), venetoclax may sometimes be considered in rare or difficult-to-treat blood cancers where BCL-2 is involved, based on a doctor’s judgment and emerging research. Always discuss with your healthcare provider whether venetoclax is appropriate for your specific condition.

Who should not take it

Venetoclax should not be taken by patients who are currently using strong CYP3A inhibitors (such as certain antifungals or antibiotics) at the start and during the dose ramp-up phase, as this can increase the risk of serious side effects like tumor lysis syndrome.

It is also not recommended for people who are pregnant, as it may harm the unborn baby, or for those who are breastfeeding. Patients with severe liver problems may need a lower dose and closer monitoring. Venetoclax is not approved for use in children. Always inform your healthcare provider of all medications and supplements you are taking to avoid harmful interactions.

Commonly used with

Venetoclax is often used in combination with other medications to treat blood cancers. For CLL and SLL, it is commonly combined with obinutuzumab or rituximab. For AML, it is used with azacitidine, decitabine, or low-dose cytarabine.

These combinations help improve the effectiveness of treatment and are tailored based on the specific type of blood cancer and patient characteristics.

Commonly tested with

Venetoclax has been tested in clinical trials with a variety of other medications, including:

• Obinutuzumab (for CLL/SLL)
• Rituximab (for CLL/SLL)
• Azacitidine (for AML)
• Decitabine (for AML)
• Low-dose cytarabine (for AML)

These combinations have been studied to determine their safety and effectiveness in treating different types of blood cancers.