AUTHOR=Li Qingfang , Cheng Li , Shen Kai , Jin Hongyu , Li Hui , Cheng Yuan , Ma Xuelei 

TITLE=Efficacy and Safety of Bcl-2 Inhibitor Venetoclax in Hematological Malignancy: A Systematic Review and Meta-Analysis of Clinical Trials

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 10 - 2019

YEAR=2019

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2019.00697

DOI=10.3389/fphar.2019.00697

ISSN=1663-9812

ABSTRACT=Abstract
Background ：B cell leukemia/lymphoma-2(BCL-2) protein is an important part
of apoptotic pathway, which is overexpressed in chronic lymphocytic leukemia
(CLL)cells, non-Hodgkin lymphoma (NHL) cells and myeloma cells. Venetoclax
(ABT-199/GDC-0199) is a highly selective bioavailable inhibitor of BCL-2 protein,
which is more effective and less valid against BCL-xL in BCL2-dependent leukemia
and lymphoma cell.
Method ：We searched PubMed database using retrieval keyword Venetoclax,
ABT-199 or GDC-0199 and investigated the data of the involved articles. Considering
variability in different studies, the overall response rate (ORR) was collected to access
the efficacy. Meanwhile, Adverse events (AEs) were summarized and event rates were
calculated to access the safety.
Results ：When patients were treated with venetoclax monotherapy, the most
common AEs were nausea, diarrhea, neutropenia, fatigue and thrombocytopenia and
neutropenia. In addition, thrombocytopenia, anemia, febrile neutropenia and
leukopenia appeared more common considering the severe AEs (defined as grade ≥3
AEs). Though the occurrence of thrombocytopenia was relatively high, it was not the
most severe type. When compared with patients treated with venetcoalx and other
drugs, nausea, diarrhea and thrombocytopenia were still the most common AEs
occurrence in the patients of all the grade. The overall event rate was 73%, which is
quite satisfactory.
Conclusion ： Venetoclax is a mild and efficient drug in treating advanced
hematological malignancy which is specially fit for the CLL patients with del[17p],
and AEs are well-tolerable. Few tumor lysis syndrome (TLS) occurred after taking the
drugs. The AEs aroused by venetovlax and combination are well-tolerable. Therefore,
the use of venetoclax monotherapy or its combination with other therapies is desirable
in hematological malignancy.