What Is Venclexta (venetoclax)?

Venetoclax, brand name Venclexta®, is part of a drug class known as B-cell lymphoma-2 (BCL-2) inhibitor.  By blocking the action of a certain protein in the body, it helps to kill cancer cells.

What Does Venetoclax Treat?

Currently, Venetoclax is not formally indicated for multiple myeloma, but it is often used in patients with t(11;14). This chromosomal abnormality occurs in about 15-20% of myeloma patients, and it is unique form of myeloma that tends to behave slightly differently than other types of myeloma. The t(11;14) means a part of chromosome 11 and 14 are merged together, which causes an increase in a pathway called the BCL-2. 

Venetoclax is a BCL-2 inhibitor that is used to treat the following cancers:

• chronic lymphocytic leukemia (CLL), which begins in the white blood cells
• small lymphocytic lymphoma (SLL), which begins mostly in the lymph nodes
• acute myeloid leukemia (AML), which begins in the white blood cells

How Is Venetoclax Given?

Venetoclax is in pill form and is taken by mouth.  

What Are Potential Side Effects of Venetoclax?

Tumor lysis syndrome

According to the Venclexta® website, this drug can cause tumor lysis syndrome (TLS). It states, "TLS is a serious side effect caused by the fast breakdown of cancer cells. TLS can cause kidney failure, the need for dialysis treatment, and may lead to death." Be sure to inform your doctor right away if you experience symptoms associated with TLS, including:

• Fever
• Chills
• Nausea
• Vomiting
• Confusion
• Shortness of breath
• Seizures
• Irregular heartbeat
• Dark or cloudy urine

Patients undergoing therapy using venetoclax should take the following precautions to prevent TLS:

1. Consult with their healthcare team to determine if you are at risk for TLS before beginning using venetoclax.
2. Drink 6-8 glasses (~56 oz) of water every day starting 2 days before your first dose, on the day of your first dose, and each time your dose increases.
3. Take medications exactly as prescribed. Note: If you are at risk for TLS, your doctor may recommend intravenous fluids before and during treatment with venetoclax.
4. Follow monitoring instructions, which may include a blood test in your first 5 weeks of treatment to test for TLS.

Neutropenia (low white blood cell count)

Your doctor will monitor your white blood cell count during treatment with venetoclax. If you have a low white blood cell count, or neutropenia, your doctor may hold the treatment or give you medications to boost your white cells.  

Infections

During treatment with venetoclax, death and serious infections such as pneumonia and blood infection (sepsis) have been reported.  It is imperative to let your healthcare team know if you have a fever or any signs of infection while taking venetoclax. This is particularly important in myeloma patients.  

What Are Myeloma Clinical Trials Using Venetoclax?

The following information is from the National Cancer Institute.

Selinexor, Venetoclax, and Dexamethasone for the Treatment of t(11;14)-Positive Relapsed or Refractory Multiple Myeloma, SELVEDge Trial 
Status: Active 
 

A Study of Venetoclax in Combination With Isatuximab and Dexamethasone for Relapsed/Refractory Multiple Myeloma 
Status: Active 
 

Finding a Clinical Trial to Match Your Needs

Myeloma clinical research has many studies enrolling patients. To help you with personalized support for identifying clinical trial options across the U.S., the IMF has partnered with SparkCures. Visit myeloma.org/sparkcures.

If you would like to explore possible participation in a clinical trial, ask your myeloma doctor if a study may be right for you and about the potential risks and benefits that may apply to you. For more information about what’s involved in study participation, read the IMF booklet Understanding Clinical Trials in Myeloma.