HMAs Plus Venetoclax Increases AML Survival, Requires More Resources

Compared with a hypomethylating agent (HMA) alone, HMA in combination with venetoclax (VEN) was associated with superior event-free survival (EFS) in patients with acute myeloid leukemia (AML). The findings were presented at the Society of Hematologic Oncology 2024 Annual Meeting in Houston, Texas.

Researchers evaluated treatment outcomes and resource utilization in adult patients with untreated AML. The study was conducted at the Hospital Italiano de Buenos Aires and involved a retrospective cohort of 96 patients (median age, 74 years) from January 2010 to June 2023.

Patients receiving the HMA-VEN combination had better clinical outcomes. Specifically, the rate of complete remission was higher in the HMA-VEN group compared with the HMA-only group (78.9% vs 26%; P<0.001). The median EFS was longer in the HMA-VEN group (17.7 months vs 6.9 months).

Overall survival (OS) also favored the HMA-VEN combination. The median OS was not yet reached in the HMA-VEN group, compared with 9.7 months for those receiving HMA alone (P=0.009). In nontransplanted patients, HMA-VEN again showed superior outcomes, with a median OS of 18.6 months versus 8.2 months in the HMA group (P=0.03).

However, the improved efficacy of the HMA-VEN combination came with an increase in resource utilization. The median hospital stay was longer for the HMA-VEN group (31 days vs nine days), and there was a higher need for antibiotics, red blood cell transfusions, and platelet transfusions. Specifically, the HMA-VEN group required a median of 17 days of antibiotic treatment versus two days for the HMA group, and median transfusion needs were also higher in the HMA-VEN group.

Although HMA-VEN combination therapy offers significantly better clinical outcomes for AML patients, it also demands substantially more healthcare resources, the study concluded. These higher resource requirements could lead to increased treatment costs, therefore “necessitating tailored strategies for resource optimization to fully harness therapeutic benefits,” the researchers wrote.

Reference

Patiño AF, Brulc E, Conca AG. Results of treatment with hypomethylating agents versus hypomethylating agents/venetoclax in patients with AML single-center experience. Abstract #AML-032. Presented at the Society of Hematologic Oncology 2024 Annual Meeting; September 4-7, 2024; Houston, Texas.