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Combining Venetoclax and TKI in Ph-Positive Advanced Myeloid Leukemias

By: Sarah Campen, PharmD
Posted: Friday, May 22, 2020

The combination of venetoclax and a tyrosine kinase inhibitor (TKI) may improve outcomes in some patients with aggressive Philadelphia chromosome (Ph)-positive advanced myeloid leukemias—including acute myeloid leukemia (AML) and chronic myeloid leukemia (CML) in myeloid blast phase—according to a retrospective study published in Acta Haematologica by Nicholas J. Short, MD, of The University of Texas MD Anderson Cancer Center, and colleagues.

The researchers focused on seven patients with Philadelphia chromosome–positive AML and nine patients with CML in myeloid blast phase who received venetoclax combined with TKI-based regimens at their institution. The patients included in the study had a median of five prior therapy cycles; nine patients had received decitabine-based, and seven received intensive chemotherapy-based regimens.

Of 15 evaluable patients, the overall response rate was 60%: 1 complete remission, 6 complete remissions with incomplete hematologic recovery, 1 morphologic leukemia-free state, and 1 partial response. The overall response rate was higher in patients with CML in myeloid blast phase than in those with Philadelphia chromosome–positive AML (75% vs. 43%, respectively), and the median overall survival was 10.9 months and 2.0 months, respectively. Of note, the two patients in the AML cohort who achieved a complete response or a complete response with incomplete hematologic recovery had the highest proportion of baseline Philadelphia chromosome–positive metaphases and BCR-ABL1 levels.

“This is the first report of clinical activity of this rational combination in a retrospective cohort of patients,” noted the investigators. They believe that further evaluation of such combination regimens is warranted in these poor-risk populations.

Disclosure: For full disclosures of the study authors, visit karger.com.



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