How is Venclexta (venetoclax) used for AML?

Q: How is Venclexta (venetoclax) used for AML?

Venclexta is given once-daily with food in combination with either azacytidine, decitabine, or low-dose cytarabine in adults with AML. It works by binding to a specific protein that is over-expressed in cancerous lymphocytes, killing them.

Medically reviewed by Carmen Pope, BPharm. Last updated on Aug 7, 2024.

Official Answer by Drugs.com

When used to treat AML (acute myeloid leukemia) Venclexta is given as an increasing dose for the first few days, with the maintenance dose starting on the fourth day. The exact maintenance dose depends on the combination agent used, which is usually either azacytidine, decitabine, or low-dose cytarabine. For example:

Day 1: Venclexta 100mg once daily
Day 2: Venclexta 200mg once daily
Day 3: Venclexta 400mg once daily
Day 4 onwards: Venclexta 400mg once daily in combination with azacytidine or decitabine OR Venclexta 600mg once daily in combination with low-dose cytarabine.

Venclexta is continued on a once-daily dosing cycle at these dosages until disease progression or unacceptable toxicity is observed. Venclexta should be taken with food and at approximately the same time each day. Tablets should be swallowed whole and not crushed, chewed, or broken before swallowing.

Venclexta (venetoclax) is approved to treat AML in adults aged 75 years or older, or in those with other medical conditions that prevent the use of intensive induction chemotherapy.

Note that Venclexta has a different dosage schedule when used to treat CLL (chronic lymphocytic leukemia) and SLL (small lymphocytic lymphoma).

How does Venclexta work?

Venclexta works by inhibiting BCL-2, which is a group of proteins that are responsible for regulating cell death by either inhibiting or inducing apoptosis. Apoptosis is an ordered form of cell death in which the contents of the cell are “packaged” for collection by immune cells. It is different from the way cells die due to an injury.

In certain cancers, such as CLL (chronic lymphocytic leukemia) and AML (acute myeloid leukemia) there is an abundance of BCL-2 on the surface of CLL and AML cells. This overexpression of BCL-2 allows tumor cells to survive for longer and has been associated with resistance to chemotherapy treatments. Laboratory research has shown that Venclexta binds to this protein and kills cancerous CLL and AML lymphocytes.

References

Venclexta (venetoclax) AbbVie Inc. https://www.drugs.com/pro/venclexta.html

Can Venclexta be used for Multiple Myeloma?

Although Venclexta is not FDA approved to treat MM, a subgroup analysis of the BELLINI clinical trial, which was halted early by the FDA due to safety concerns, revealed that Venclexta in combination with other treatments may be beneficial for those with relapsed or refractory MM bearing the t(11;14) translocation or with high levels of BCL-2. Continue reading

How does Venclexta work?

Venclexta's mechanism of action involves binding directly to a protein called BCL-2, which is overexpressed on some cancer cells. When Venclexta binds to BCL-2, it displaces other proteins, which help activate apoptosis -- or programmed cell death. Continue reading

What is Idhifa used to treat?

Idhifa (enasidenib) is an oral medicine used to treat adults with acute myeloid leukemia (AML) and specific genetic mutation known as IDH2 (isocitrate dehydrogenase-2). Idhifa is used in patients with AML that has returned after initial treatment (relapsed) or has not responded to treatment (refractory). Continue reading

How is Venclexta (venetoclax) used for AML?

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