Venclexta

Venclexta is the brand name for venetoclax, an oral small‑molecule inhibitor of BCL‑2, a protein that helps some cancer cells survive. It is approved for certain hematologic cancers, most notably chronic lymphocytic leukemia (CLL) and acute myeloid leukemia (AML). The drug is developed and marketed by AbbVie and Genentech.

Approved uses include CLL/SLL with 17p deletion, and, in combination with obinutuzumab, treatment‑naive CLL/SLL. For AML, venetoclax is used with a hypomethylating agent (azacitidine or decitabine) or with low‑dose cytarabine in adults newly diagnosed who are not candidates for intensive chemotherapy.

Mechanism of action: venetoclax selectively inhibits BCL‑2, lowering the threshold for apoptosis in malignant cells and promoting cancer cell death. This makes it effective against CLL and AML cells that depend on BCL‑2 for survival.

Dosing and administration: Venetoclax is given as an oral tablet with a planned ramp‑up to a target dose, typically 400 mg daily for many regimens, to reduce tumor lysis syndrome (TLS) risk. The exact regimen depends on indication and concurrent drugs, especially CYP3A inhibitors. TLS prophylaxis and laboratory monitoring are required during initiation and dose escalations. Dose adjustments may be needed for liver impairment or drug interactions.

Safety: Common adverse events include neutropenia, anemia, thrombocytopenia, nausea, diarrhea, and fatigue. TLS is a key safety concern and requires preventive measures. Venetoclax can interact with several medicines via CYP3A metabolism, necessitating monitoring and possible dose changes. The drug carries warnings about pregnancy and fetal risk.