Matthew Steven Davids, MD, MMSc on Venetoclax Plus R-EPOCH in Hematologic Cancers

The chronic lymphocytic leukemia expert spoke about the possible use of venetoclax plus dose-adjusted R-EPOCH in various hematologic patient populations.

In an interview with CancerNetwork®, Matthew Steven Davids, MD, MMSc, an attending physician in the Lymphoma Program of the Division of Hematologic Malignancies and associate director of the CLL Center at the Dana-Farber Cancer Institute, spoke about the possible use of venetoclax (Venclexta) plus dose-adjusted R-EPOCH (rituximab [Rituxan], etoposide phosphate [Etopophos], prednisone [Rayos], vincristine sulfate [Marqibo], cyclophosphamide, and doxorubicin hydrochloride) in various hematologic patient populations.

Venetoclax plus dose-adjusted R-EPOCH was originally studied in a multicenter phase II study in patients with chronic lymphocytic leukemia (CLL) who developed Richter’s syndrome. The results of the study, presented at the 2020 American Society of Clinical Oncology (ASCO) Virtual Scientific Program, indicated that the treatment combination could be effective in this patient population.


So in terms of the potential for this combination in other cancer types, I think that's a great question because you know, this is a concept, chemosensitization, that certainly could apply across different cancers. And, you know, we saw last year the publication of the CAVALLI study, which combined venetoclax with R-CHOP, or G-CHOP (GA101), also known as obinutuzumab (Gazyva), and that also looked like a promising approach for patients with diffuse large B-cell lymphoma and follicular lymphoma. And there's other studies that are starting to look at this in other lymphoid malignancies as well, including also other myeloid cancers.

And so I think in the blood cancer domain, this is definitely a promising approach. There's no reason why this type of approach couldn't work in solid tumors either in terms of chemosensitization, although it may not be as straightforward as targeting BCL-2, we may actually need some of the other molecules in the growing toolkit of BH3-mimetic drugs that target other anti-apoptotic proteins because the dependence of different solid tumors may be very different and more heterogeneous than it is in hematologic malignancies.