Loading
MURANO showed that a fixed two-year course of the BCL2 inhibitor venetoclax with rituximab kept relapsed chronic lymphocytic leukaemia away for far longer than chemo-immunotherapy, and that many patients stayed in remission for years after stopping.
MURANO randomised 389 patients with relapsed or refractory chronic lymphocytic leukaemia to venetoclax for two years plus rituximab for the first six months, or to six cycles of bendamustine and rituximab. The primary endpoint was investigator-assessed progression-free survival.
Venetoclax-rituximab lengthened progression-free survival dramatically and produced far higher rates of undetectable minimal residual disease in blood and marrow, which predicted long remissions after therapy stopped. Overall survival also favoured the venetoclax arm with longer follow-up. The regimen was approved in the United States in June 2018 and made fixed-duration, chemotherapy-free treatment the model that the later CLL14 and CLL13 trials carried into first-line use.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
389 enrolled.
Median follow-up 23.8 months
Source6 of 194 patients
Source| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Progression-free survival at 2 years (investigator-assessed)primary | Venetoclax + rituximab | 194 | 84.9% | 0.17 (0.11 to 0.25) | <0.001 | link |
| Bendamustine + rituximab | 195 | 36.3% | ||||
| Progression-free survival at 2 years, chromosome 17p deletion | Venetoclax + rituximab | - | 81.5% | 0.13 (0.05 to 0.29) | - | link |
| Bendamustine + rituximab | - | 27.8% | ||||
| Progression-free survival at 2 years, no 17p deletion | Venetoclax + rituximab | - | 85.9% | 0.19 (0.12 to 0.32) | - | link |
| Bendamustine + rituximab | - | 41% | ||||
| Grade 3-4 tumour lysis syndrome | Venetoclax + rituximab | 194 | 3.1% | - | - | link |
Shares BCL-2 inhibitors, AbbVie (incl. ImmunoGen, Capstan), Venetoclax, Small-molecule kinase inhibitors and the tag subtype-trials.
Shares AbbVie (incl. ImmunoGen, Capstan), Chronic lymphocytic leukaemia, Small-molecule kinase inhibitors and the tag subtype-trials.
Shares AbbVie (incl. ImmunoGen, Capstan) and the tag subtype-trials.
Shares AbbVie (incl. ImmunoGen, Capstan) and the tag subtype-trials.
Shares Roche / Genentech and the tag subtype-trials.
Shares Roche / Genentech and the tag subtype-trials.
Shares Roche / Genentech and the tag subtype-trials.
Shares Roche / Genentech and the tag subtype-trials.