Use of Venetoclax in Patients with Relapsed or Refractory Acute Myeloid Leukemia: The PETHEMA Registry Experience

Autor: Jorge Labrador, Miriam Saiz-Rodríguez, Dunia de Miguel, Almudena de Laiglesia, Carlos Rodríguez-Medina, María Belén Vidriales, Manuel Pérez-Encinas, María José Sánchez-Sánchez, Rebeca Cuello, Alicia Roldán-Pérez, Susana Vives, Gonzalo Benzo-Callejo, Mercedes Colorado, María García-Fortes, María José Sayas, Carmen Olivier, Isabel Recio, Diego Conde-Royo, Álvaro Bienert-García, María Vahi, Carmen Muñoz-García, Cristina Seri-Merino, Mar Tormo, Ferran Vall-llovera, María-Ángeles Foncillas, David Martínez-Cuadrón, Miguel Ángel Sanz, Pau Montesinos
Rok vydání: 2022
Předmět:
Zdroj: Cancers
r-IGTP. Repositorio Institucional de Producción Científica del Instituto de Investigación Germans Trias i Pujol
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r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe
r-FISABIO. Repositorio Institucional de Producción Científica
Cancers; Volume 14; Issue 7; Pages: 1734
ISSN: 2072-6694
Popis: Simple Summary The use of venetoclax combined with hypomethylating agents or low-dose cytarabine in patients with newly diagnosed acute myeloid leukemia unfit for intensive chemotherapy was recently approved. However, the evidence in relapse or refractory patients is still scarce. The cohort of patients included in our study was heavily pretreated and had a poor performance status. It is still necessary to identify those patients at higher risk of early death who would not benefit from this type of treatment. For these ultra-high-risk patients, other treatment strategies should be followed. The effectiveness of venetoclax (VEN) in relapsed or refractory acute myeloid leukemia (RR-AML) has not been well established. This retrospective, multicenter, observational database studied the effectiveness of VEN in a cohort of 51 RR-AML patients and evaluated for predictors of response and overall survival (OS). The median age was 68 years, most were at high risk, 61% received >= 2 therapies for AML, 49% had received hypomethylating agents, and ECOG was >= 2 in 52%. Complete remission (CR) rate, including CR with incomplete hematological recovery (CRi), was 12.4%. Additionally, 10.4% experienced partial response (PR). The CR/CRi was higher in combination with azacitidine (AZA; 17.9%) than with decitabine (DEC; 6.7%) and low-dose cytarabine (LDAC; 0%). Mutated NPM1 was associated with increased CR/CRi. Median OS was 104 days (95% CI: 56-151). For the combination with AZA, DEC, and LDAC, median OS was 120 days, 104 days, and 69 days, respectively; p = 0.875. Treatment response and ECOG 0 influenced OS in a multivariate model. A total of 28% of patients required interruption of VEN because of toxicity. Our real-life series describes a marginal probability of CR/CRi and poor OS after VEN-based salvage. Patients included had very poor-risk features and were heavily pretreated. The small percentage of responders did not reach the median OS.
Databáze: OpenAIRE
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