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Treatment With Ivosidenib or Enasidenib Under Study in IDH-Mutant AML

By: Joseph Fanelli
Posted: Tuesday, February 8, 2022

For patients with IDH-mutant de novo acute myeloid leukemia (AML), treatment with ivosidenib or enasidenib—an IDH1 inhibitor or IDH2 inhibitor, respectively—combined with induction and consolidation therapies may result in high complete remission, complete remission with incomplete hematologic recovery, and complete remission with incomplete platelet recovery rates, according to findings presented at the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 1276). Overall survival rates were also improved with the IDH inhibitors, concluded Martin S. Tallman, MD, of Memorial Sloan Kettering Cancer Center, New York, and colleagues.

In this phase I trial, 153 patients with newly diagnosed IDH1-mutant or IDH2-mutant AML were treated with induction therapy in combination with either ivosidenib (60 patients) or enasidenib (93 patients). Following induction, each patient received up to four cycles of consolidation therapy while continuing the IDH inhibitor.

Among the patients treated with ivosidenib, 37 (88.1%) with de novo AML achieved complete remission, complete remission with incomplete hematologic recovery, or complete remission with incomplete platelet recovery, compared with 10 who had secondary AML (55.6%). In the patients treated with enasidenib, 45 with de novo AML had some type of complete response (80.4%), compared with the 22 patients with secondary AML (62.9%).

For patients who received ivosedinib, IDH1 mutations were cleared in 16 of 41 patients (39.0%), with 16 of 20 found to have achieved measurable residual disease (MRD) negativity. Those who received enasidenib saw IDH2 mutations cleared in 15 of 64 patients (23.4%), and 10 of 16 achieved MRD negativity. Of the patients who achieved complete remission, 7 of 42 treated with ivosedinib (16.7%) and 7 of 51 treated with enasidenib (13.7%) experienced relapse or death.

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


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