Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions
Venetoclax Regimens Assessed in Patients with AML
Am J Hematol; ePub 2017 Dec 23; DiNardo, et al
Certain low-intensity chemotherapy regimens appear to be reasonable options even in patients with relapsed/refractory acute myeloid leukemia (AML) and other myeloid disorders, according to a study involving 43 individuals. Participants’ median age was 68 years. Most had AML, and the remainder had either myelodysplastic syndrome or blastic plasmacytoid dendritic cell neoplasm. They were treated with hypomethylating agents (HMAs) or low-dose cytarabine, in combination with venetoclax in the salvage setting. Among the results:
- 72% received HMAs and 19% low-dose cytarabine with venetoclax.
- 9 patients (21%) achieved an objective response, including 2 complete responses, 3 CRi, and 4 morphologic leukemia-free state.
- Patients survived a median of 3 months.
- Estimated 6-month survival was 24%.
- ~One-fourth of patients with intermediate-risk cytogenetics responded.
- 27% of those with IDH1/2-mutant responded, as did half RUNX1-mutated patients.
- Of the 3 responding patients with adverse cytogenetics, all had concurrent RUNX1 mutations.
DiNardo C, Rausch C, Benton C, et al. Clinical experience with the BCL2-inhibitor venetoclax in combination therapy for relapsed and refractory acute myeloid leukemia and related myeloid malignancies. [Published online ahead of print December 23, 2017]. Am J Hematol. doi:10.1002/ajh.25000.
This Week's Must Reads
Must Reads in AML
Immune system changes play a role in AML relapse, Christopher MJ et al. N Engl J Med. 2018 Oct 31. doi: 10.1056/NEJMoa1808777.
Venetoclax plus HMA studied in AML, DiNardo C et al. Blood. 2018 Oct 25. doi: 10.1182/blood-2018-08-868752.
T cell infusion effective in PML, Muftuoglu M et al. N Engl J Med. 2018 Oct 11;379:1443-51
Higher AML, MDS risk linked to autotransplants, Radivoyevitch T et al. Leuk Res. 2018 Jul 19. pii: S0145-2126(18)30160-7
Tibsovo for AML with IDH1 mutation, FDA approves first targeted treatment for patients with relapsed or refractory acute myeloid leukemia who have a certain genetic mutation, FDA press release