Photo Credit: Nemes Laszlo

The following is a summary of “Clinical outcomes of hypomethylating agents plus Venetoclax as frontline treatment in patients 75 years and older with acute myeloid leukemia: Real-world data from eight US academic centers,” published in the February 2024 issue of Hematology by Abaza et al.

Researchers performed a retrospective study investigating the real-world effectiveness and tolerability of combining Venetoclax (VEN) with hypomethylating agents (HMAs) in elderly patients with newly diagnosed acute myeloid leukemia (AML) unfit for intensive chemotherapy, focusing on mutational landscape and treatment patterns.

They evaluated the real-world outcomes of 204 elderly patients (aged ≥75 years) diagnosed with AML and treated with HMAs plus VEN from eight US academic centers.

The results showed 64 patients achieved complete remission (CR) 38% and 43 CR with incomplete count recovery (CRi 26%), resulting in a CR/CRi rate of 64%, with a median response duration of 14.2 months (95% CI: 9.43, 22.1). Among responders, 63 patients relapsed (59%) with a median OS after relapse of 3.4 months (95% CI, 2.4, 6.7). The median OS for the entire population was 9.5 months (95% CI, 7.85–13.5), with OS significantly worse among patients with TP53-mutated AML (2.5 months) and improved in patients harboring NPM1, IDH1, and IDH2 mutations (13.5, 18.3, and 21.1 months, respectively). The 30-day and 60-day mortality rates were 9% and 19%, respectively. 

Investigators concluded that elderly AML patients treated with HMAs plus VEN had a shorter OS  than reported in the VIALE-A trial, highlighting the need for better treatment options after this therapy fails.

Source: onlinelibrary.wiley.com/doi/full/10.1002/ajh.27231