TEXT ON SCREEN:
VENCLEXTA CLL Portraits: A look at CLL patients and the doctors who treat them

Featuring Dr. Nakhle Saba, Associate Professor of Medicine in Hematology-Oncology at Tulane University
Hypothetical patient profile All patients and their results are different.

TEXT ON SCREEN:
Disclaimers:

• This video is sponsored by AbbVie and Genentech, Inc., a member of the Roche Group
• The healthcare provider included in this video is presenting information on behalf of AbbVie and Genentech, Inc., a member of the Roche Group

TEXT ON SCREEN:
Dr. Nakhle Saba, Associate Professor of Medicine in Hematology-Oncology at Tulane University

PLEASE SEE IMPORTANT SAFETY INFORMATION AT THE END OF THIS VIDEO AND FULL PRESCRIBING INFORMATION.

Hypothetical patient profile. All patients and their results are different.

Dr. Saba:
Hi, I’m Doctor Nakhle Saba, Associate Professor of Medicine in Hematology-Oncology at Tulane University. Today, I’d like to share a hypothetical CLL patient profile and discuss some of the factors that help me choose a treatment for my own patients.

My treatment decision varies by patient type. Like many other cancers, personalized medicine made its way to CLL. And by patient types, I mean the patient characteristics, disease risk stratification, patient’s age, patient comorbidities, and definitely, definitely patients’ preference.

TEXT ON SCREEN:
Martin, 82 years old
Patient with previously untreated chronic lymphocytic leukemia (CLL)

Dr. Saba:
Martin is a type of patient that I see quite often in my practice. I’ve had a good amount of experience using VENCLEXTA plus GAZYVA with patients like Martin who have previously untreated CLL.

When I consider treating a patient like Martin, I take a number of things into account. I’ll consider his age and his full clinical background, as well as how the treatment might affect his day-to-day life.

TEXT ON SCREEN:
Martin, 82 years old
Patient with previously untreated chronic lymphocytic leukemia (CLL)

Comorbidities: Hypertension; cardiovascular disease
ECOG PS: 2
CIRS: 9
Prognostic Risk Factors Unmutated IGHV, no 17p deletion

ECOG=Eastern Cooperative Oncology Group; PS=performance status; CIRS=cumulative illness rating scale; IGHV=immunoglobulin heavy-chain variable gene; PFS=progression-free survival.

Actor Portrayal

Dr. Saba:
Martin is 82 years old with comorbidities that include hypertension and cardiovascular disease. You can see the rest of his clinical background here. Looking at all aspects of his profile, I would strongly consider VENCLEXTA plus GAZYVA, or VEN+G, due to this regimen’s proven efficacy and safety. This regimen offers a chance for durable progression-free survival without continuous treatment, which can mean a patient like Martin has a chance to get back to a life without a daily reminder of his treatment and disease.

TEXT ON SCREEN
VENCLEXTA is indicated for the treatment of adult patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).

Continue viewing this video for Important Safety Information at the end of the video.

Serious and sometimes fatal adverse reactions occurred with VENCLEXTA treatment.

Dr. Saba:

VENCLEXTA is indicated for the treatment of adult patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).

Continue viewing for Important Safety Information at the end of the video.

Serious and sometimes fatal adverse reactions occurred with VENCLEXTA treatment. Warnings and precautions include tumor lysis syndrome, neutropenia, infections, immunizations, embryo-fetal toxicity, and increased mortality in patients with multiple myeloma when VENCLEXTA is added to bortezomib and dexamethasone.

Appropriate precautions should be taken by the healthcare provider.

TEXT ON SCREEN:
Dr. Nakhle Saba, Associate Professor of Medicine in Hematology-Oncology at Tulane University

Dr. Saba:
VENCLEXTA regimens offer my patients proven efficacy and a well-studied safety profile.

TEXT ON SCREEN:
CLINICAL OUTCOMES
PATIENT EXPERIENCE
NO ONGOING OOP COSTS

OOP=out of pocket

Dr. Saba:
VENCLEXTA regimens also offer patients the chance for time off treatment and no ongoing treatment exposure.

Another benefit is that there are no additional out-of-pocket costs with the VENCLEXTA regimen after the patient has completed treatment per the recommended dosing. This can be very important for a retired patient like Martin.

TEXT ON SCREEN:
[ADVERSE REACTIONS BY BODY SYSTEM TABLE]

*Includes multiple adverse reaction terms.
VEN+G=VENCLEXTA+GAZYVA; GClb=GAZYVA+chlorambucil.

Dr. Saba:

Considering Martin’s age, I am also encouraged that VENCLEXTA regimens have proven efficacy and a well-studied safety profile. I always discuss with my patients the risks associated with the VENCLEXTA regimen. The most common adverse reactions in the CLL14 trial were neutropenia, diarrhea, and fatigue.

TEXT ON SCREEN:
[GRADE 3/4 AEs GRAPHIC] (%)⁵*^†

GRADE 3/4 AEs (%)⁵*^†

• Other important Grade 3/4 AEs
  
  • Febrile neutropenia: 4% during combination-therapy period. 0% during single-agent period, 1% during off treatment period
  • Pneumonia: 3% during combination-therapy period. 1% during single-agent period, 3% during off treatment period
  • TLS: 1% during combination-therapy period, 0% during single-agent period, 0% during off treatment period
• VEN+G combination-therapy period (6 cycles): Includes Grade 3 and 4 treatment-emergent AEs occurring on or before last exposure date of GAZYVA + 29 days
• VENCLEXTA single-agent period (6 cycles): Includes Grade 3 and 4 AEs occurring after the start of the VEN monotherapy period to last date of VEN + 29 day
• Off treatment: Includes Grade 3 and 4 AEs occurring after 29 days and up to 6 months after treatment completion
• Multiple occurrences of the same AE in an individual during the same treatment period are counted only once for that treatment period

*Based on data as of clinical cutoff date of November 14, 2022.
^†The chart reflects Grade 3/4 AEs with incidence ≥5%.
AE=adverse event; TLS=tumor lysis syndrome.

Dr. Saba:
Here you see the incidence of Grade 3 and 4 adverse events from the 6-year follow-up of the CLL14 trial. This chart shows the incidences during VEN+G combination therapy, during single-agent VENCLEXTA treatment, as well as when the patients were off treatment. Neutropenia was the most common Grade 3 or 4 adverse reaction. Therefore, I monitor complete blood counts throughout the treatment period. I hold the VENCLEXTA dose for severe neutropenia and resume at the same or a reduced dose depending on how many times the neutropenia has occurred. I also consider supportive measures, including antimicrobials and G-CSF.

TEXT ON SCREEN:
Cardiovascular adverse events in patients treated with VEN+G^3*†
[CARDIOVASCULAR ADVERSE EVENTS IN PATIENTS TREATED WITH VEN+G3 TABLE]

The analysis was not powered to demonstrate a statistically significant difference between VEN+G and GClb adverse events

*Based on data as of clinical data cutoff date of August 23, 2019.³
Shown are Grade 3, 4, and 5 events with frequency 1% or higher and their corresponding Any Grade rates.^3
‡Includes multiple adverse reaction terms.³

Dr. Saba:
Martin has a history of hypertension and cardiovascular disease, which is why the additional data showing the cardiovascular safety profile in patients treated with VEN+G are important to consider.

I think VENCLEXTA plus GAZYVA is a very appropriate treatment for Martin for multiple reasons. His age, comorbidities, and risk stratification for his CLL were well represented in CLL14.

Dr. Saba:
For all these reasons, including proven efficacy, well-studied safety, a chance for time off treatment, and no ongoing out-of-pocket costs, a VENCLEXTA-based regimen is my first choice for patients like Martin.

TEXT ON SCREEN:
CLINICAL OUTCOMES
PATIENT EXPERIENCE
NO ONGOING OOP COSTS

OOP=out of pocket

ISI Voiceover/TEXT ON SCREEN:
Important Safety Information

Contraindication

• Concomitant use of VENCLEXTA with strong CYP3A inhibitors at initiation and during ramp-up phase is contraindicated in patients with CLL/SLL due to the potential for increased risk of tumor lysis syndrome (TLS).

Tumor Lysis Syndrome

• Tumor lysis syndrome, including fatal events and renal failure requiring dialysis, has occurred in patients treated with VENCLEXTA.
• VENCLEXTA can cause rapid reduction in tumor and thus poses a risk for TLS at initiation and during the ramp-up phase in all patients, and during reinitiation after dosage interruption in patients with CLL/SLL. Changes in blood chemistries consistent with TLS that require prompt management can occur as early as 6 to 8 hours following the first dose of VENCLEXTA and at each dose increase. TLS, including fatal cases, has been reported after a single 20 mg dose.
• In patients with CLL/SLL who followed the current (5 week) dose ramp-up and the TLS prophylaxis and monitoring measures, the rate of TLS was 2% in the VENCLEXTA CLL/SLL monotherapy trials. The rate of TLS remained consistent with VENCLEXTA in combination with obinutuzumab or rituximab. With a 2- to 3-week dose ramp-up and higher starting dose in patients with CLL/SLL, the TLS rate was 13% and included deaths and renal failure.
• The risk of TLS is a continuum based on multiple factors, particularly reduced renal function, tumor burden, and type of malignancy. Splenomegaly may also increase the risk of TLS in patients with CLL/SLL.
• Assess all patients for risk and provide appropriate prophylaxis for TLS, including hydration and anti-hyperuricemics. Monitor blood chemistries and manage abnormalities promptly. Employ more intensive measures (IV hydration, frequent monitoring, hospitalization) as overall risk increases. Interrupt dosing if needed; when restarting VENCLEXTA follow dose modification guidance in the Prescribing Information.
• Concomitant use of VENCLEXTA with P-gp inhibitors or strong or moderate CYP3A inhibitors increases venetoclax exposure, which may increase the risk of TLS at initiation and during the ramp-up phase, and requires VENCLEXTA dose reduction.

Neutropenia

• In patients with CLL, Grade 3 or 4 neutropenia developed in 63% to 64% of patients and Grade 4 neutropenia developed in 31% to 33% of patients when treated with VENCLEXTA in combination and monotherapy studies. Febrile neutropenia occurred in 4% to 6% of patients.
• Monitor complete blood counts. Interrupt dosing for severe neutropenia and resume at same or reduced dose. Consider supportive measures including antimicrobials and growth factors (e.g., G-CSF).

Infections

• Fatal and serious infections such as pneumonia and sepsis have occurred in patients treated with VENCLEXTA. Monitor patients for signs and symptoms of infection and treat promptly. Withhold VENCLEXTA for Grade 3 and 4 infection until resolution and resume at same or reduced dose.

Immunization

• Do not administer live attenuated vaccines prior to, during, or after treatment with VENCLEXTA until B-cell recovery occurs. Advise patients that vaccinations may be less effective.

Embryo-Fetal Toxicity

• VENCLEXTA may cause embryo-fetal harm when administered to a pregnant woman. Advise females of reproductive potential to use effective contraception during treatment and for 30 days after the last dose.

Increased Mortality in Patients with Multiple Myeloma when VENCLEXTA is Added to Bortezomib and Dexamethasone

• In a randomized trial (BELLINI; NCT02755597) in patients with relapsed or refractory multiple myeloma, the addition of VENCLEXTA to bortezomib plus dexamethasone, a use for which VENCLEXTA is not indicated, resulted in increased mortality. Treatment of patients with multiple myeloma with VENCLEXTA in combination with bortezomib plus dexamethasone is not recommended outside of controlled clinical trials.

Adverse Reactions

• In patients with CLL receiving combination therapy with obinutuzumab, serious adverse reactions were most often due to febrile neutropenia and pneumonia (5% each). The most common adverse reactions (≥20%) of any grade were neutropenia (60%), diarrhea (28%), and fatigue (21%). Fatal adverse reactions that occurred in the absence of disease progression and with onset within 28 days of the last study treatment were reported in 2% (4/212) of patients, most often from infection.
• In patients with CLL receiving combination therapy with rituximab, the most frequent serious adverse reaction (≥5%) was pneumonia (9%). The most common adverse reactions (≥20%) of any grade were neutropenia (65%), diarrhea (40%), upper respiratory tract infection (39%), fatigue (22%), and nausea (21%). Fatal adverse reactions that occurred in the absence of disease progression and within 30 days of the last VENCLEXTA treatment and/or 90 days of the last rituximab were reported in 2% (4/194) of patients.
• In patients with CLL/SLL receiving monotherapy, the most frequent serious adverse reactions (≥5%) were pneumonia (9%), febrile neutropenia (5%), and sepsis (5%). The most common adverse reactions (≥20%) of any grade were neutropenia (50%), diarrhea (43%), nausea (42%), upper respiratory tract infection (36%), anemia (33%), fatigue (32%), thrombocytopenia (29%), musculoskeletal pain (29%), edema (22%), and cough (22%). Fatal adverse reactions that occurred in the absence of disease progression and within 30 days of venetoclax treatment were reported in 2% of patients in the VENCLEXTA monotherapy studies, most often (2 patients) from septic shock.

Drug Interactions

• Concomitant use with a P-gp inhibitor or a strong or moderate CYP3A inhibitor increases VENCLEXTA exposure, which may increase VENCLEXTA toxicities, including the risk of TLS. Consider alternative medications or adjust VENCLEXTA dosage and monitor more frequently for adverse reactions. Resume the VENCLEXTA dosage that was used prior to concomitant use of a P-gp inhibitor or a strong or moderate CYP3A inhibitor 2 to 3 days after discontinuation of the inhibitor.
• Patients should avoid grapefruit products, Seville oranges, and starfruit during treatment as they contain inhibitors of CYP3A.
• Avoid concomitant use of strong or moderate CYP3A inducers.
• Monitor international normalized ratio (INR) more frequently in patients receiving warfarin.
• Avoid concomitant use of VENCLEXTA with a P-gp substrate. If concomitant use is unavoidable, separate dosing of the P-gp substrate at least 6 hours before VENCLEXTA.

Lactation

• Advise women not to breastfeed during treatment with VENCLEXTA and for 1 week after the last dose.

Females and Males of Reproductive Potential

• Advise females of reproductive potential to use effective contraception during treatment with VENCLEXTA and for 30 days after the last dose.
• Based on findings in animals, VENCLEXTA may impair male fertility.

Hepatic Impairment

• Reduce the dose of VENCLEXTA for patients with severe hepatic impairment (Child-Pugh C); monitor these patients more frequently for adverse reactions. No dose adjustment is recommended for patients with mild (Child-Pugh A) or moderate (Child-Pugh B) hepatic impairment.

TEXT ON SCREEN:
References

1. VENCLEXTA Prescribing Information. 2. Data on file, AbbVle Inc. 6-year data ABVRRTl76226. 3. Al-Sawaf O, Zhang C, Tandon M, et al. Venetoclax plus obinutuzurnab versus chlorarmbuciI plus obinutuzurnab for previously untreated chronic lymphocytic leukaemia (CLL14): follow-up results from a multicentre, open-label, randomized, phase 3 trial. Lancet Oncol. 2020;21(9);1188-1200.

Text on Screen: Patient Initiation Treatment With VENCLEXTA^® (venetoclax tablets) Regimens

Christina Patterson, PA-C

Cancer Care Associates of York

York, PA

US-VENC-220202

PLEASE SEE IMPORTANT SAFETY INFORMATION AT THE END OF THIS VIDEO AND FULL PRESCRIBING INFORMATION ON THIS WEBSITE

Text on Screen: Disclaimer

• This video is sponsored by AbbVie and Genentech, Inc., a member of the Roche Group. 
• The healthcare provider included in this video is presenting information on behalf of AbbVie and Genentech, Inc., a member of the Roche group. 

Text on Screen: 

Christina Patterson, PA-C

Cancer Care Associates of York

York, PA

Christina: 

• Hello, my name is Christina Patterson and I am a physician assistant practicing at Cancer Care Associates of York in York, Pennsylvania
• Welcome to the VENCLEXTA patient initiation video for patients with previously untreated or relapsed, refractory chronic lymphocytic leukemia or CLL
• Each year, I work with around 40 patients with CLL in our community oncology practice who are being treated with VENCLEXTA
• My goal is to share our experiences with VENCLEXTA and, in particular, the preparations and planning that we do when initiating treatment

Text on Screen: Indication in CLL

VENCLEXTA is a BCL-2 inhibitor indicated¹:

• For the treatment of adult patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL)

Christina: 

• It is important to note that VENCLEXTA is a BCL-2 inhibitor that is indicated for the treatment of adult patients with chronic lymphocytic leukemia or small lymphocytic lymphoma

Text on Screen: Select Important Safety Information 

• Concomitant use of VENCLEXTA with strong CYP3A inhibitors at initiation and during ramp-up is contraindicated in patients with CLL/SLL due to the potential for increased risk of tumor lysis syndrome (TLS).
• Tumor lysis syndrome, including fatal events and renal failure requiring dialysis, has occurred in patients treated with VENCLEXTA. The risk of TLS is a continuum based on multiple factors, particularly reduced renal function, tumor burden, and type of malignancy. Assess all patients for risk and provide appropriate prophylaxis for TLS, including hydration and anti-hyperuricemics. Monitor blood chemistries and manage abnormalities promptly. Employ more intensive measures (IV hydration, frequent monitoring, hospitalization) as overall risk increases. Interrupt dosing if needed; when restarting VENCLEXTA follow dose modification guidance in the Prescribing Information.
• Concomitant use of VENCLEXTA with P-gp inhibitors or strong or moderate CYP3A inhibitors increase venetoclax exposure, which may increase the risk of TLS at initiation and during the ramp-up phase, and requires VENCLEXTA dose reduction. 
• Grade 3 or 4 neutropenia occurred in patients treated with VENCLEXTA. Monitor complete blood counts and for signs of infection; manage as medically appropriate.
• Fatal and serious infections such as pneumonia and sepsis have occurred in patients with VENCLEXTA. Monitor patients for signs and symptoms of infection and treat promptly. Withhold VENCLEXTA for Grade 3 or 4 infection until resolution.
• Do not administer live attenuated vaccines prior to, during, or after treatment until B-cell recovery occurs. 
• VENCLEXTA may cause embryo-fetal harm. Advise females of reproductive potential to use effective contraception during treatment and for 30 days after the last dose. 

Text on Screen: PLEASE SEE IMPORTANT SAFETY INFORMATION AT THE END OF THIS VIDEO AND FULL PRESCRIBING INFORMATION ON THIS WEBSITE.

Christina:

• In my experience, I find that the best way to be successful with VENCLEXTA is to educate your team and your patients, and to have a plan in place before treatment even begins

Text on Screen: The dose ramp-up was designed to gradually debulk tumor burden and decrease the risk of TLS¹

Christina:

• The dosing schedules shown here were specifically designed to initiate treatment with VENCLEXTA to help reduce tumor burden in the debulking phase and decrease the risk of TLS
• Regardless of the line of treatment in CLL, VENCLEXTA dosing ramps up over a period of 5 weeks
• In the first week of treatment, the patients will receive 20 mg per day of VENCLEXTA orally. The dose will increase weekly to 50, 100, 200, and eventually 400 mg per day
• We explain to our patients that because of how VENCLEXTA works, we need to gradually ramp-up dosing, and apply prophylaxis and appropriate monitoring
• Upon completion of the 5-week ramp-up, we’ll continue dosing at 400 mg per day until the end of the prescribed treatment regimen, unless VENCLEXTA delay, decrease, or discontinuation is required

Text on Screen: PLEASE SEE IMPORTANT SAFETY INFORMATION AT THE END OF THIS VIDEO AND FULL PRESCRIBING INFORMATION ON THIS WEBSITE.

Christina:

• When your patient has been prescribed VENCLEXTA, you should ensure that the VENCLEXTA Starting Pack is ordered
• The starter pack was designed to facilitate dosing according to the ramp-up schedule for weeks 1 through 4 with weekly, color-coded, wallet blister packs. The dosing for Week 5 onwards is provided to the patient in a bottle
• To order, please contact your specialty distributor. A list can be found on www.venclextahcp.com

Text on Screen: Initiating VENCLEXTA with GAZYVA^® (Obinutuzumab) or rituximab

• STEP 1: ASSESS prior to VENCLEXTA
• STEP 2: PREPARE at least 2 days prior to first dose 
• STEP 3: INITIATE 5-week VENCLEXTA ramp-up

Christina:

• Let's take a closer look at how we should initiate treatment
• To that end, there are 3 key steps to this process
• It starts with assessing tumor burden
• Then, preparing for the first dose of VENCLEXTA
• And finally, initiating VENCLEXTA treatment with the dose ramp-up protocol
• I’d like to emphasize that these steps are the same, regardless of whether your patients are receiving VENCLEXTA with an anti-CD20 monoclonal antibody or as monotherapy

Text on Screen: Considerations for TLS with VENCLEXTA¹

• VENCLEXTA can cause rapid reduction in tumor and thus poses a risk for TLS at the initial 5-week ramp-up phase in all patients, and during reinitiation after dosage interruption
• Changes in blood chemistries consistent with TLS that require prompt management can occur as early as 6 to 8 hours following the first dose of VENCLEXTA and at each dose increase
• The risk of TLS is a continuum based on multiple factors, particularly reduced renal function (CrCl <80 mL/min) and tumor burden; splenomegaly may also increase the risk

Christina:

• In order to prepare our team prior to treatment with VENCLEXTA, I sit down with our nurses and schedulers and, based on a patient’s tumor burden and other clinical characteristics, we will adjust their monitoring and labs to ensure that we are giving our patients the tailored care that they need

Text on Screen: Considerations for TLS with VENCLEXTA¹

• Consider all patient comorbidities before final determination of prophylaxis and monitoring schedule
• The risk of TLS may decrease as tumor burden decreases
• Reassess the risk of TLS when reinitiating VENCLEXTA after a dosage interruption lasting more than 1 week during the ramp-up phase, or more than 2 weeks after completion of ramp-up. Institute prophylaxis and monitoring as needed

Appropriate prophylaxis can help lower the risk of TLS.

Assess Blood Chemistry and Correct Pre-existing Abnormalities Prior to Initiation of Treatment:

• Potassium
• Uric acid
• Phosphorus
• Calcium
• Creatinine 

Christina: 

• In the past we have reached out to our patient advocates at our center for help on various challenges
• Planning the treatment out doesn’t end with the logistics, however, as it requires that both our staff and our patients know and understand every part of the treatment process—essentially why we are doing what we are doing

Text on Screen: Patients With Low or Medium Tumor Burden May Be Initiated in the Outpatient Setting¹

• Consider all patient comorbidities before final determination of prophylaxis and monitoring schedule
• Patients who may be initiated in the outpatient setting:
  • Low tumor burden: those with all lymph nodes (LN) <5 cm and an absolute lymphocyte count (ALC) <25 x 10⁹/L
  • Medium tumor burden: those with any LN from 5 cm to <10 cm or an ALC ≥25 x 10⁹/L
• For the first dose of 20 mg and 50 mg, consider hospitalization for patients with medium tumor burden and CrCl <80 mL/min

Christina: 

• Note that, depending on the assessed tumor burden, I may be administering the initial 20 mg and 50 mg doses of VENCLEXTA in the outpatient or the hospital setting with the related lab monitoring
• From our experience, some patients will need to be in the hospital initially
• To put this into perspective, in the CLL14 study in the first-line setting, 22% of patients were characterized as having a high risk of TLS, which would have necessitated an in-hospital start with VENCLEXTA

Text on Screen: Patients With Low or Medium Tumor Burden May Be Initiated in the Outpatient Setting^1,3

• Patients with high tumor burden—those with an LN ≥10 cm or those with ALC ≥25 x 10⁹/L and any LN ≥5 cm—should be initiated in the hospital¹
• In the CLL14 trial, TLS risk category was chosen based on investigator discretion, LN size, and ALC^1,3
  • Baseline characteristics in the CLL14 trial: 13% (29/216) of VEN+G patients had low, 64% (139/216) had medium, and 22% (48/216) had high TLS risk²

Christina:

• The majority of patients in CLL14 were characterized as having a low or medium risk of TLS, and thus this majority could start VENCLEXTA and be managed in an outpatient setting, unless other factors, such as comorbidities, suggest the patient should initiate VENCLEXTA in the hospital setting
• Starting in the hospital requires a slightly different focus for patients and nurses than when it is done in the outpatient setting
• One way we have improved the logistics of the onboarding is that we have worked with our electronic medical records to design VENCLEXTA order sets based on Prescribing Information and our experience

Text on Screen: It is important to go over the Medication Guide with the patient. 

Christina:

• We stress to them the importance of hydration, particularly during the dose ramp-up period. I would say this is a really important thing that patients have control over in making treatment initiation a success
• We give each patient a specific outline for the dates to begin taking allopurinol and start the hydration protocol. We will also specify the dates and times of each dose, as well as the dates and times for their lab work and related follow-up appointments
• By having the days of the week and appointments filled in ahead of time, patients can actually be marking off when things have been completed and track their progress through ramp-up
• This can help make things as simple as possible for our patients
• Please see the full Prescribing Information for complete preparation recommendations
• Our schedulers need to understand the timing behind when we need our patients to get labs and how this will impact their appointment time 

Text on Screen: Plan Ahead for Labs¹

• Evaluate blood chemistries (potassium, uric acid, phosphorous, calcium, and creatinine) 
• Review in real time

Christina: 

• Thus, patients and their providers understand that, while it may seem like there is a lot of upfront monitoring and labs during VENCLEXTA initiation, that is simply part of the process
• It is important to plan ahead for labs to make sure patients are appropriately monitored

Text on Screen: Plan Ahead for Labs¹

• Evaluate blood chemistries (potassium, uric acid, phosphorous, calcium, and creatinine) 
• Review in real time

Christina:

• A few ways to get stat labs are: To get them in your own outpatient clinic, which is what we do. Another option might be to get stat labs in a local or affiliated outpatient hospital. Another common option could be to get them at a local or national reference lab
• What’s important is that the lab understands why you need a response quickly

Text on Screen: PLEASE SEE IMPORTANT SAFETY INFORMATION AT THE END OF THIS VIDEO AND FULL PRESCRIBING INFORMATION ON THIS WEBSITE. 

Christina:

• Ultimately, the treatment initiation for the VENCLEXTA regimen requires some planning for you and your patient
• My biggest piece of advice with VENCLEXTA is to educate your team, educate your patients, and simply be prepared
• In my opinion, both academic centers and community practices should be able to successfully initiate VENCLEXTA
• Thank you for taking the time to walk with me through the initiation of treatment with VENCLEXTA for patients with previously untreated or relapsed, refractory CLL

Text on Screen: [ISI]

References:

1. VENCLEXTA Prescribing Information.

2. Fischer K, Al-Sawaf O, Bahlo J, et al. Venetoclax and obinutuzumab in patients with CLL and coexisting conditions. N Engl J Med. 2019;380(23):2225-2236.

3. Fischer K, Al-Sawaf O, Bahlo J, et al. Venetoclax and obinutuzumab in patients with CLL and coexisting conditions. N Engl J Med. 2019;380(23):2225-2236 (suppl appendix).

VO: Please see accompanying full Prescribing Information.

Text on Screen: This presentation is by [AbbVie logo] [Genentech logo]

VO: This video has been presented on behalf of AbbVie and Genentech.

US-VENC-220202

TEXT ON SCREEN:
[VENCLEXTA logo lockup]
VENCLEXTA Portraits: A Closer Look at Patient Types

Actor portrayals.

Dr. Fakhri:
Hello, I'm Dr. Bita Fakhri.

TEXT ON SCREEN:
Dr. Bita Fakhri Assistant Professor of Medicine in the Division of Hematology at Stanford Medical Center

Dr. Saba:
Hello, I'm Dr. Nahkle Saba.

TEXT ON SCREEN:
Dr. Nakhle Saba Associate Professor of Medicine in Hematology-Oncology at Tulane University

Dr. Fakhri:
And I would like to share with you why I choose VENCLEXTA for a wide variety of patient types.

TEXT ON SCREEN:
Actor portrayals.

A wide variety of patient types

In 3 insightful videos
About 3 patient types

TEXT ON SCREEN:
See what your peers have to say about choosing VENCLEXTA.

TEXT ON SCREEN:
[VENCLEXTA logo lockup]

Visit www.venclextahcp.com to hear a new perspective

VENCLEXTA and its design are registered trademarks of AbbVie Inc. US-VENC-230206/October 2023