Venetoclax for the treatment of multiple myeloma

Abstract

ABSTRACTIntroduction: Treatment of multiple myeloma (MM) in the relapsed setting remains challenging, despite recent impressive advances in the management of these patients. Venetoclax (ABT-199) is a BCL-2 inhibitor recently approved by the US food and drug administration for treatment of chronic lymphocytic leukemia but the drug has shown activity in a number of hematological malignancies. Venetoclax has broadened the treatment options for patients with relapsed or refractory MM. Approximately, 20% of myeloma patients will exhibit t (11;14) associated with high BCL-2 expression making venetoclax an attractive therapeutic option. The efficacy of venetoclax is not uniquely restricted to this population.Areas covered: This review will summarize the mechanism of action, toxicity profile, and published data on venetoclax use in MM, moving the field toward personalized medicine in the treatment of myeloma.Expert commentary: Numerous phase 1/2 clinical trials are evaluating the efficacy and safety of venetoclax monotherapy and in combinations in the relapse setting. These trials show better outcomes in the subgroup of patients harboring t(11;14).