Posted: Tuesday, February 9, 2021
The hypomethylating agent decitabine plus venetoclax may prove to be a more effective treatment option than intensive chemotherapy for older patients with acute myeloid leukemia (AML), particularly for those who may be at an increased risk for treatment-related mortality. Marina Y. Konopleva, MD, PhD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues reported that patients who received the combination therapy seemed to achieve higher rates of complete remission, lower rates of relapse and mortality, and longer overall survival than those treated with intensive chemotherapy. The results were published in the American Journal of Hematology.
The researchers retrospectively analyzed patients with newly diagnosed AML who received 10-day decitabine with venetoclax (n = 85) or intensive chemotherapy (n = 85). Patients’ baseline characteristics were comparable in the two groups. A validated treatment-related mortality score was used to classify patients as being at high- or low risk for treatment-related mortality with intensive chemotherapy.
Complete remission rates and complete remission with incomplete hematologic recovery rates were higher with venetoclax than intensive chemotherapy (81% vs. 52%; P < .001). Similarly, the patients treated with decitabine plus venetoclax had lower rates of relapse (34% vs. 56%; P = .01) and lower 30-day mortality rates (1% vs. 24%; P < .01) than those patients treated with intensive chemotherapy. The researchers also reported significantly longer overall survival with venetoclax compared with intensive chemotherapy (12.4 months vs. 4.5 months; P < .01). For patients classified as being at high or low risk for treatment-related mortality, decitabine plus venetoclax was linked to significantly higher complete remission rates, lower 30-day mortality, and longer overall survival compared with intensive chemotherapy.
“Clinical trials evaluating venetoclax with hypomethylating agents in ‘fitter’ and younger patients are ongoing,” the researchers reported. “These results can help in designing future randomized trials of venetoclax with hypomethylating agents versus intensive chemotherapy.”
Disclosure: For full disclosures of the study authors, visit onlinelibrary.wiley.com.