| Autor: |
Tapan M. Kadia, Patrick K. Reville, Xuemei Wang, Caitlin R. Rausch, Gautam Borthakur, Naveen Pemmaraju, Naval G. Daver, Courtney D. DiNardo, Koji Sasaki, Ghayas C. Issa, Maro Ohanian, Guillermo Montalban-Bravo, Nicholas J. Short, Nitin Jain, Alessandra Ferrajoli, Kapil N. Bhalla, Elias Jabbour, Koichi Takahashi, Rashmi Malla, Kelly Quagliato, Rashmi Kanagal-Shamanna, Uday R. Popat, Michael Andreeff, Guillermo Garcia-Manero, Marina Y. Konopleva, Farhad Ravandi, Hagop M. Kantarjian |
| Rok vydání: |
2023 |
| Předmět: |
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| Zdroj: |
Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 40(33) |
| ISSN: |
1527-7755 |
| Popis: |
PURPOSE The combination of venetoclax and 5-azacitidine (5-AZA) for older or unfit patients with acute myeloid leukemia (AML) improves remission rates and survival compared with 5-AZA alone. We hypothesized that the addition of venetoclax to cladribine (CLAD)/low-dose araC (low-dose cytarabine [LDAC]) alternating with 5-AZA backbone may further improve outcomes for older patients with newly diagnosed AML. METHODS This is a phase II study investigating the combination of venetoclax and CLAD/LDAC alternating with venetoclax and 5-AZA in older (≥ 60 years) or unfit patients with newly diagnosed AML. The primary objective was composite complete response (CR) rate (CR plus CR with incomplete blood count recovery); secondary end points were overall survival, disease-free survival (DFS), overall response rate, and toxicity. RESULTS A total of 60 patients were treated; median age was 68 years (range, 57-84 years). By European LeukemiaNet, 23%, 33%, and 43% were favorable, intermediate, and adverse risk, respectively. Fifty-six of 60 evaluable patients responded (composite CR: 93%) and 84% were negative for measurable residual disease. There was one death (2%) within 4 weeks. With a median follow-up of 22.1 months, the median overall survival and DFS have not yet been reached. The most frequent grade 3/4 nonhematologic adverse events were febrile neutropenia (n = 33) and pneumonia (n = 14). One patient developed grade 4 tumor lysis syndrome. CONCLUSION Venetoclax and CLAD/LDAC alternating with venetoclax and 5-AZA is an effective regimen among older or unfit patients with newly diagnosed AML. The rates of overall survival and DFS are encouraging. Further study of this non–anthracycline-containing backbone in younger patients, unfit for intensive chemotherapy, as well as comparisons to standard frontline therapies is warranted. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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