Real-World Experience of Adults With Acute Myeloid Leukemia on Hypomethylating Agents With or Without Venetoclax at a Comprehensive Cancer Center.

Autor:	Freeman T; Department of Pharmacy, The Ohio State University, Columbus, OH, USA., Williams K; Department of Pharmacy, The Ohio State University, Columbus, OH, USA., Puto M; Department of Pharmacy, The Ohio State University, Columbus, OH, USA., Waller A; Department of Pharmacy, The Ohio State University, Columbus, OH, USA., McLaughlin EM; Department of Biomedical Informatics, The Ohio State University, Columbus, OH, USA., Blachly JS; Department of Hematology, The Ohio State University, Columbus, OH, USA., Roddy J; Department of Pharmacy, The Ohio State University, Columbus, OH, USA.
Jazyk:	angličtina
Zdroj:	World journal of oncology [World J Oncol] 2023 Feb; Vol. 14 (1), pp. 40-50. Date of Electronic Publication: 2023 Feb 26.
DOI:	10.14740/wjon1557
Abstrakt:	Background: Venetoclax (VEN) in combination with hypomethylating agent (HMA) therapy is a standard treatment option for patients with newly diagnosed acute myeloid leukemia (AML); however, data are limited in the relapsed or refractory (R/R) populations and in those with poor-risk disease. A retrospective review was conducted involving patients with AML who received HMA alone or in combination with VEN (VEN + HMA). Methods: VEN + HMA was compared to HMA alone in first-line and R/R settings. Patients were stratified by specific HMA and line of therapy. The primary endpoint was overall response rate (ORR) up to 6 months from start of treatment. Results: Fifty-two patients were evaluated for efficacy and 78 patients for safety. ORR was 67% (VEN + HMA) versus 80% (HMA) in the first line and 50% versus 22% in R/R setting. A greater clinical benefit was seen with VEN + HMA compared to HMA in both lines of therapy (first-line: 87% vs. 80%; R/R: 75% vs. 67%). The median duration of response was longer with VEN + HMA first-line, but shorter in the R/R setting compared to HMA (8.3 vs. 7.2 months and 2.5 vs. 3.7 months, respectively). Of the 32 patients who responded to therapy, 63% had a complex karyotype. Survival benefits were greater with VEN + HMA in both lines of therapy, although not statistically significant. Grade 3/4 neutropenia was reported in all patients receiving VEN, and 95% of these patients also experienced grade 3/4 thrombocytopenia. There were three cases of tumor lysis syndrome. Conclusion: The addition of VEN to HMA has consistently shown benefit as first-line treatment and may have some benefit in R/R settings as well. Further studies are needed to compare across various lines of treatment and unfavorable disease. Dynamic strategies that improve toxicity management should be considered. Competing Interests: Julianna Roddy, PharmD, BCOP, is currently employed with Merck Research Labs, Merck & Inc. Her contribution to this study was completed while she was employed at the James Cancer Hospital, Ohio State University. James Blachly, MD, has performed consulting and/or advisory board work for AbbVie, AstraZeneca, Astellas, KITE Pharma, and INNATE Pharma. (Copyright 2023, Freeman et al.)
Databáze:	MEDLINE
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