Trial reportBlood2022
Venetoclax plus dose-adjusted R-EPOCH for Richter syndrome.
Trial report in Blood, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03054896 (Venetoclax Plus Dose-adjusted R-EPOCH or R-CHOP for Richter's Syndrome), which is not on this map. Cited by 37 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Venetoclax Plus Dose-adjusted R-EPOCH or R-CHOP for Richter's Syndrome
Who cites it
37 citing papers in PubMed, 2 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- Evidence-based investigation of the efficacy and safety of venetoclax-containing regimens versus chemoimmunotherapy in chronic lymphocytic leukemia.Naunyn-Schmiedeberg's archives of pharmacology · 2025Pooled it
- Response to therapy in Richter syndrome: a systematic review with meta-analysis of early clinical trials.Frontiers in immunology · 2023Pooled it
- Blinatumomab after R-CHOP bridging therapy for patients with Richter transformation: a phase 2 multicentre trial.Nature communications · 2024Trial
- A phase 2 study of nivolumab combined with ibrutinib in patients with diffuse large B-cell Richter transformation of CLL.Blood advances · 2023Trial
- Glofitamab monotherapy in patients with Richter transformation: safety and efficacy from a phase 1 study.Blood advances · 2026Article
- Article
- Molecular Pathogenesis and Targeted Treatment of Richter Transformation.Biomedicines · 2026Review
- The Evolving Therapeutic Landscape of Richter Transformation.Current hematologic malignancy reports · 2025Review
- Richter's transformation: status quo and quo vadis.Annals of hematology · 2025Review
- CD19 CAR T-Cell Therapy in Richter Transformation: A Multicentre Retrospective Analysis by the European Research Initiative on Chronic Lymphocytic Leukaemia.Journal of cellular and molecular medicine · 2025Article
- Richter Transformation in Chronic Lymphocytic Leukemia: Current Treatment Challenges and Evolving Therapies.International journal of molecular sciences · 2025Review
- The Role of Tumor Microenvironment and Targeted Therapy in Chronic Lymphocytic Leukemia.Current issues in molecular biology · 2025Review
- High rate of complete responses induced by platinum-based regimen with BTK inhibitors in Richter syndrome.Blood advances · 2025Article
- Updates on the Treatment of Richter's Syndrome, Including Novel Combination Approaches.Cancers · 2025Review
- Updates in the Management of Richter Transformation.Cancers · 2024Review
- Venetoclax Plus Intensified Chemoimmunotherapy as a Bridge to Allogeneic Stem Cell Transplantation in Richter Syndrome: Report of Two Cases.Hematology reports · 2024Article
- Article
- Blockage of BCL-XL overcomes venetoclax resistance across BCL2+ lymphoid malignancies irrespective of BIM status.Blood advances · 2024Article
- Molecular Subtypes and the Role of TP53 in Diffuse Large B-Cell Lymphoma and Richter Syndrome.Cancers · 2024Review
- Richter transformation acquiringEJHaem · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors at 4 institutions in 1 country.
Funding
Abstract
Richter syndrome (RS) of chronic lymphocytic leukemia (CLL) is typically chemoresistant, with a poor prognosis. We hypothesized that the oral Bcl-2 inhibitor venetoclax could sensitize RS to chemoimmunotherapy and improve outcomes. We conducted a single-arm, investigator-sponsored, phase 2 trial of venetoclax plus dose-adjusted rituximab, etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (VR-EPOCH) to determine the rate of complete response (CR). Patients received R-EPOCH for 1 cycle, then after count recovery, accelerated daily venetoclax ramp-up to 400 mg, then VR-EPOCH for up to 5 more 21-day cycles. Responders received venetoclax maintenance or cellular therapy off-study. Twenty-six patients were treated, and 13 of 26 (50%) achieved CR, with 11 achieving undetectable bone marrow minimal residual disease for CLL. Three additional patients achieved partial response (overall response rate, 62%). Median progression-free survival was 10.1 months, and median overall survival was 19.6 months. Hematologic toxicity included grade ≥3 neutropenia (65%) and thrombocytopenia (50%), with febrile neutropenia in 38%. No patients experienced tumor lysis syndrome with daily venetoclax ramp-up. VR-EPOCH is active in RS, with deeper, more durable responses than historical regimens. Toxicities from intensive chemoimmunotherapy and venetoclax were observed. Our data suggest that studies comparing venetoclax with chemoimmunotherapy to chemoimmunotherapy alone are warranted. This trial was registered at www.clinicaltrials.gov as #NCT03054896.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.