A phase 2 study shows that combining venetoclax and ibrutinib can produce strong and lasting responses in patients with marginal zone lymphoma, including those newly diagnosed and those whose disease has returned or resisted treatment.
In the study of 14 patients, 79% responded to the treatment within 16 weeks, and 29% achieved a complete response. Long-term results were also encouraging, with about 56% of patients remaining free from disease progression after five years. Additionally, 40% of patients had no detectable cancer at a very sensitive level, and some remained cancer-free for years even after stopping treatment, suggesting that shorter treatment durations may be possible in the future.
Side effects were generally manageable and similar to what is already known for these drugs. Common issues included diarrhea, nausea, and low white blood cell counts. Some patients experienced serious infections, so careful monitoring is important. Notably, there were no cases of tumor lysis syndrome, a potentially serious complication.
Patients first received ibrutinib alone for four weeks, followed by a gradual addition of venetoclax. Treatment continued until the disease progressed, but researchers now suggest exploring shorter, time-limited treatment approaches based on the durable responses seen.